ObjectiveTo explore the main mechanism of self-precipitation formed during the decoction of Sinitang（SNT）， and to provide a research basis for exploring the differences in the toxic and effective components of this compound. MethodsThe average precipitation yields of SNT， Glycyrrhizae Radix et Rhizoma（GRR）-Aconiti Lateralis Radix Praeparata（ALRP） decoction（GF）， ALRP-Zingiberis Rhizoma（ZR） decoction（FJ）， GRR-ZR decoction（GJD）， ALRP decoction（FZ）， ZR decoction（GJ） and GRR decoction（GC） were determined. The four main self-precipitation samples of SNT， GF， FZ and GC were physically characterized by particle size， scanning electron microscopy（SEM）， pH， total dissolved solids（TDS）， conductivity， and Fourier transform infrared spectroscopy（FT-IR） analysis. The chemical compositions of SNT decoction and its different phases was identified by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap-MS） for SNT， SNT self-precipitation and SNT supernatant， and the contents of its main toxic and effective components were determined by high performance liquid chromatography（HPLC）. ResultsPrecipitation yield results of the 7 samples of SNT decoction and single decoction showed that SNT had the highest self-precipitation yield. The formation of SNT self-precipitation was mainly related to the reaction between ALRP and GRR components to form complexes， and FT-IR showed that GRR had the greatest influence on the formation of self-precipitation. A total of 110 components were identified in the SNT decoction， including 100 components in the SNT self-precipitation and 106 components in the SNT supernatant. And quantitative results of the main toxic and effective components revealed that the reaction between ALRP and GRR components formed complexes， resulting in the following content hierarchy for free components：SNT decoctionsupernatantself-precipitation， these components included free liquiritin， benzoylmesaconine， benzoylaconitine， benzoylhypacoitine， liquiritigenin， aconitine， hypoaconitine， isoliquiritigenin and ammonium glycyrrhizinate. ConclusionSNT exhibits spontaneous precipitation during compound decoction， with GRR exerting the greatest influence on its formation. This suggests GRR plays a significant role in the detoxification of SNT. The differences in the self-precipitated toxic-effective components of SNT compound decoction primarily manifest as changes in component content， reflecting the characteristics of SNT "deposition in vitro and sustained release in vivo" and the importance of "administered at draught" in the clinical application of SNT.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Chronic cerebral hypoperfusion leads to white matter injury (WMI), which subsequently causes neurodegeneration and even cognitive impairment. However, due to the lack of treatment specifically for WMI, novel recognized and effective therapeutic strategies are urgently needed. In this study, we found that honokiol and magnolol, two compounds derived from Magnolia officinalis, significantly facilitated the differentiation of primary oligodendrocyte precursor cells (OPCs) into mature oligodendrocytes, with a more prominent effect of the former compound. Moreover, our results demonstrated that honokiol treatment improved myelin injury, induced mature oligodendrocyte protein expression, attenuated cognitive decline, promoted oligodendrocyte regeneration, and inhibited astrocytic activation in the bilateral carotid artery stenosis model. Mechanistically, honokiol increased the phosphorylation of serine/threonine kinase (Akt) and mammalian target of rapamycin (mTOR) by activating cannabinoid receptor 1 during OPC differentiation. Collectively, our study indicates that honokiol might serve as a potential treatment for WMI in chronic cerebral ischemia.
Magnolia ; White Matter ; Brain Ischemia/metabolism* ; Oligodendroglia/metabolism*

Objective:To translate the Glaucoma Symptom Scale (GSS) into Chinese, and to test its reliability and validity.Methods:Following the Brislin questionnaire translation principles, GSS was translated, back-translated and culturally adapted, and the Chinese version of GSS was formed. From January 2021 to June 2022, a total of 210 glaucoma patients in Ophthalmology Outpatient and Inpatient Department of Class Ⅲ Grade A hospitals in Hefei were enrolled as the research objects by the convenience sampling method. The items of the Chinese version of GSS were screened by correlation coefficient method, critical ratio method and Cronbach's α coefficient. The reliability of the Chinese version of GSS was tested using Cronbach's α coefficient, split-half reliability and test-retest reliability. The validity of the GSS was evaluated by content validity and construct validity. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive ability of the Chinese version of GSS, and to determine the sensitivity, specificity and the most appropriate critical value of GSS. Pearson correlation analysis was used to explore the correlation between the total score of GSS and the score of each item. A total of 210 questionnaires were distributed in this study, and 205 were effectively received, with an effective recovery rate of of 97.62% (205/210) .Results:A total of 2 common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 50.64%. With clinician's diagnosis as the gold standard, the area under the curve of the Chinese version of GSS was 0.916 (95% CI: 0.886-0.947, P<0.01). The optimal critical score of the scale was 73, and the sensitivity and specificity were 85.2% and 87.3%. The concordant Kappa value of the two diagnostic results was 0.749 ( P<0.01). The Cronbach's α coefficient, split-half reliability and test-retest reliability of the Chinese version of GSS were 0.812, 0.781 and 0.912, respectively. Conclusions:The Chinese version of the GSS has good reliability and validity, and is suitable for the screening of glaucoma patients in China.

Humans ; Female ; Prevalence ; Breast Neoplasms ; Cancer Survivors ; Non-alcoholic Fatty Liver Disease ; Liver

【Objective】 To explore the influence of anti-HLA-Ⅰ with different mean fluorescence intensity (MFI) on the efficacy of HLA-A and -B gene matching platelet transfusion, so as to provide scientific data for clinical platelet gene matching transfusion strategy. 【Methods】 A total of 81 PTR patients had applied for HLA-Ⅰgene matched platelets from the platelet gene database established by our laboratory, and 28 (MFI <5 000) of them needed further avoiding of partial donor-specific antibodies and they were enrolled as the research subjects. According to the platelet MFI value of HLA-Ⅰ antibody-targeting antigen, they were divided into negative transfusion group (MFI <500) (group A) and positive transfusion groups (MFI≥500) ; the latter were further divided into group B (500≤MFI <1 000), group C (1 000≤MFI <3 000) and group D (MFI≥3 000) according to MFI value. Corrected count increment (CCI) in platelet count was used to compare the platelet transfusion effect in 4 groups. 【Results】 Among 28 platelet recipients with MFI <5 000, 19(67.86%) patients successfully received 72 effective transfusions. The first CCI (×10⁹/L) in groups A, B, C and D were 10.27±7.46, 7.58±4.75 (P>0.05), 17.36±7.63 (P>0.05) and -0.77±2.30 (P<0.05), respectively. There was no statistical difference among group A, B and C. 【Conclusion】 The application of HLA-Ⅰ gene matching platelets in PTR patients can adjust the MFI threshold(<2 000) appropriately according to the patient′s condition without compromising the platelet transfusion effect.

【Objective】 To analyze the specificity and Eplets of HLA allele-specific antibody in patients with platelet transfusion refractoriness (PTR). 【Methods】 HLA-A and B genotypes were detected by PCR-SBT, and HLA-Ⅰ antibodies in patients′ serum were detected by Luminex single antigen beads coating method. IPD-IMGT/HLA Database was used to find the differential amino acids of allele-specific antibodies, and HLA Eplet database was used to analyze the registry Eplets. 【Results】 HLA allele-specific antibodies were found in 12 out of 82 patients with PTR.After sequence alignment, a total of 18 differential amino acids were found, such as 19E>19K, 166D>116E, 167G>167W and so on. Among these differential amino acids, 16 registry Eplets were retrieved such as 19E>19K, 95I>95L, 113YD>113HD and so on.The amino acid substitution of 166DG>166EW, 70Q>70H, 67S>67Y, 94I>94T, 82LR>82RG, and 211G>211A may form new Eplets that have not been registered.The antigens of A11, A24, B15, B27 and B38 can be further subdivided into HLA narrow specific antigens. 【Conclusion】 It was found that there were HLA allele-specific antibodies in patients with PTR, suggesting that high-resolution typing of HLA-A, B should be carried out for these patients and platelet donors in HLA compatible transfusion of PTR.

Objective:To explore the main hindering factors of nutritional care for family caregivers of patients with digestive system neoplasms after surgery, so as to provide reference for nursing workers to improve the quality of nutritional care for family caregivers and formulate personalized intervention programs.Methods:From January to April 2021, the phenomenological research method was used to select 14 family caregivers of patients with digestive system neoplasms after surgery in the First Affiliated Hospital of Anhui Medical University for semi-structured interviews, and Colaizzi 7-step analysis method was used to analyze and collate the data.Results:The obstacles to nutritional care for family caregivers of patients with digestive system neoplasms after surgery extracted 4 themes and 9 sub-themes. The first theme was insufficient awareness of nutritional care, including caregivers' insufficient awareness of the importance of nutritional care and lack of awareness of nutritional risks related to assisted eating. The second theme was the lack of nutritional care ability, including lack of nutrition knowledge of caregivers, poor practical ability of caregivers and poor compliance and initiative of caregivers. The third theme was the difficulty in obtaining and using nutritional information, including limited access to information for caregivers and difficulties in using information for caregivers. The fourth theme was caregiver role barriers in nutritional care, including lack of social support and heavy family financial burden.Conclusions:Nursing workers can formulate individualized interventions for family caregivers' nutritional care barriers, promote the improvement of nutritional care quality of them and then improve patients' nutritional status and quality of life.

Objective:To explore the main hindering factors of nutritional care for family caregivers of patients with digestive system neoplasms after surgery, so as to provide reference for nursing workers to improve the quality of nutritional care for family caregivers and formulate personalized intervention programs.Methods:From January to April 2021, the phenomenological research method was used to select 14 family caregivers of patients with digestive system neoplasms after surgery in the First Affiliated Hospital of Anhui Medical University for semi-structured interviews, and Colaizzi 7-step analysis method was used to analyze and collate the data.Results:The obstacles to nutritional care for family caregivers of patients with digestive system neoplasms after surgery extracted 4 themes and 9 sub-themes. The first theme was insufficient awareness of nutritional care, including caregivers' insufficient awareness of the importance of nutritional care and lack of awareness of nutritional risks related to assisted eating. The second theme was the lack of nutritional care ability, including lack of nutrition knowledge of caregivers, poor practical ability of caregivers and poor compliance and initiative of caregivers. The third theme was the difficulty in obtaining and using nutritional information, including limited access to information for caregivers and difficulties in using information for caregivers. The fourth theme was caregiver role barriers in nutritional care, including lack of social support and heavy family financial burden.Conclusions:Nursing workers can formulate individualized interventions for family caregivers' nutritional care barriers, promote the improvement of nutritional care quality of them and then improve patients' nutritional status and quality of life.

Hyperparathyroidism is a common endocrine disease that seriously affects human health, depending on its etiology, which can be divided into three types: primary, secondary and tertiary. In clinical practice, we found that some primary hyperparathyroidism may be secondary or tertiary hyperparathyroidism caused by insufficient calcium intake and/or vitamin D deficiency/insufficiency, and become a common type of hyperparathyroidism. The daily calcium intake of Chinese people is generally insufficient. Vitamin D can promote the absorption of calcium, but vitamin D deficiency/insufficiency is also a worldwide public health problem. Long-term hypocalcemia will stimulate parathyroid hyperplasia and secrete excessive parathyroid hormone, resulting in parathyroid hyperfunction (pre-hyperparathyroidism) and then secondary hyperparathyroidism, both of which may damage bone and release calcium into blood, leading to diseases of multiple organs and tissues. The detection of bone metabolism indexes such as calcium, magnesium, phosphorus, parathyroid hormone and vitamin D may be helpful for the early diagnosis of pre-hyperparathyroidism and hyperparathyroidism. Supplementation of calcium and vitamin D in early stage can control the development of the disease and change "unpreventable and uncontrollable" into "preventable and controllable" . The health screening of bone metabolism indexes and parathyroid ultrasonography should be advocated, and the prevention and treatment of calcium and/or vitamin D insufficiency associated parathyroid hyperfunction and hyperparathyroidism should be strengthened, so as to greatly improve the bone health, urinary calculus, metastatic vascular calcification and systemic abnormal calcium migration and precipitation in the population.