Objective:To establish the HPLC fingerprint of Bolbostemmatis Rhizoma standard decoction; To determine the three effective components with similar structure by quantitative analysis of multi-components by single marker (QAMS); To evaluate the quality of Bolbostemmatis Rhizoma standard decoction.Methods:HPLC was adopted to establish the fingerprints of 15 batches of Bolbostemmatis Rhizoma standard decoction. The Chromatographic column was Waters XBridge Phenyl (4.6 mm×250 mm, 5 μm). The mobile phase was acetonitrile-0.1% phosphoric acid solution with gradient elution. Cluster analysis (HCA) and principal component analysis (PCA) were conducted based on the relative peak area of common peaks. The same method as the fingerprint was used to establish QAMS of tubeimoside A, B, C on Bolbostemmatis Rhizoma standard decoction.Results:There were 14 common peaks in the fingerprint of Bolbostemmatis Rhizoma standard decoction. It was confirmed that the peak 3 was L-tryptophan, the peak 11 was tubeimoside B, the peak 12 was tubeimoside C, and the peak 13 was tubeimoside A. 15 batches of Bolbostemmatis Rhizoma standard decoction from different origins were divided into 3 categories by HCA and PCA. There was no significant difference between QAMS and the external standard method (ESM) through the system suitability inspection. Conclusion:This method is accurate, reliable and has good specificity, which can effectively evaluate the quality of Bolbostemmatis Rhizoma standard decoction.

ObjectiveTo explore the mechanism of Taohong Siwutang in regulating the levels of inflammatory mediators， cysteine-dependent aspartate-specific protease Caspase-14， and recombinant envoplakin （EVPL） in the mouse model of psoriasis. MethodForty-eight BALB/c mice were randomized into blank， model， methotrexate tablets（3.6×10^-4 g·kg^-1）， and low-， medium-， and high-dose Taohong Siwutang groups（7.14，14.28，28.56 g·kg^-1）. The mouse model of psoriasis-like skin lesion was induced by applying 5% imiquimod cream on the back of mice， and drug intervention was carried out at the same time. The psoriasis area and severity index （PASI） was scored by photographing. Hematoxylin-eosin staining was employed to observe the pathological changes of the skin， which was evaluated based on the Baker score. The levels of interleukin （IL）-2， IL-17， IL-22， and IL-23 in the peripheral blood of mice were measured by the enzyme-linked immunosorbent assay. Immunohistochemical staining was adopted to detect the positive expression of Caspase-14 and EVPL in mouse skin lesions. Western blot and real-time polymerase chain reaction were employed to determine the protein and mRNA levels， respectively， of IL-2， IL-17， IL-22， IL-23， Caspase-14， and EVPL in mouse skin lesions. ResultCompared with the blank group， the model group showed increased PASI score and Baker score， elevated levels of IL-2， IL-17， IL-22， and IL-23 in the peripheral blood， up-regulated mRNA and protein levels of IL-2， IL-17， IL-22 and IL-23， and down-regulated mRNA and protein levels and positive expression of Caspase-14 and EVPL in skin lesions （P<0.05）. Compared with the model group， drug interventions reduced the PASI score and Baker score， lowered the levels of IL-2， IL-17， IL-22， and IL-23 in the peripheral blood， down-regulated the mRNA and protein levels of IL-2， IL-17， IL-22， and IL-23， and up-regulated the mRNA and protein levels and positive expression of Caspase-14 and EVPL in skin lesions （P<0.05）. ConclusionTaohong Siwutang demonstrates good anti-inflammatory effect and skin barrier repair function in the treatment of psoriasis. It can significantly reduce the levels of inflammatory mediators in the peripheral blood and skin lesions and promote the expression of Caspase-14 and EVPL involved in skin barrier repair in the mouse model of psoriasis.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

Objective:To identify the relationship between the CT arterial radiomics score and the treatment response to neoadjuvant therapy for pancreatic cancer.Methods:The clinical data of 243 pancreatic cancer patients who received surgical resection after neo-adjuvant therapy in the First Affiliated Hospital of Naval Medical University from March 2017 to March 2023 were retrospectively analyzed. Based on the tumor regression grade (TRG), the patients were divided into good response group (TRG 0-1, n=30) and non-good response group (TRG 2-3, n=213). The clinical, radiological and pathological features were compared between two groups. Fully-automated segmentation tool was used for segmenting the arterial CT scan of pancreatic tumor before and after treatment. Python package was applied to extract the radiomics features of tumors after segmentation and the extracted features were reduced and chosen using the least absolute shrinkage and selection operator (Lasso) logistic regression algorithm. Lasso logistic regression formula was applied to calculate the arterial radiomics score. Univariate and multivariate logistic regression models were used to analyze the association between arterial radiomics score and treatment response to neoadjucant therapy. Receiver operating-characteristics (ROC) curve was drawn and area under curve (AUC), specificity, sensitivity and accuracy for evaluating the treatment response were calculated. The clinical usefulness of arterial radiomics score for diagnosing the response of neoadjuvant treatment for pancreatic cancer were determined by decision curve analysis (DCA) . Results:A total of 330 arterial radiomics CT features were obtained, and 9-selected arterial phase features associated with treatment response were determined after being reduced by the Lasso logistic regression algorithm. Univariate analysis showed that the arterial radiomics score, three-dimensional diameter after neoadjuvant therapy, pancreatic contour, T stage, N stage, Peri-pancreatic nerve invasion, lymph-vascular space invasion (LVSI) and invasion of duodenum were all associated with treatment response (all P value <0.05). Multivariate logistic regression analyses confirmed that arterial radiomics score was obviously associated with the neoadjuvant treatment response ( P<0.001). At the cut-off value of 1.93, AUC of the arterial radiomics score for diagnosing neoadjuvant treatment response was 0.92, and the specificity, sensitivity and accuracy was 86.7%, 84.5% and 84.8%. DCA demonstrated that when the percentage for predicting the treatment response by using the arterial radiomics score was >0.2, the patients could benefit from the application of arterial radiomics score for evaluating neoadjuvant therapy response. Conclusions:The arterial radiomics score was strongly correlated with the neoadjuvant treatment response of pancreatic cancer, and can accurately predict neoadjuant treatment efficacy.

Objective To duplicate the existing model of intracranial oculomotor nerve injury in rats,and propose a new method of orbital cavity clamping oculomotor nerve,evaluate the respective advantages of the two models.Methods Male SD rats were used as experimental animals,and two different methods of preparing oculomotor nerve injury models were compared.Sphenopalatine foramen approach group:clamp the initial segment of the oculomotor nerve from the opening of the upper edge of the orbit for 10 s.The skull base approach group,the temporal bone was removed and the infratentorial segment of the oculomotor nerve was clampped for 10 s.Taking the success rate,survival rate and survival status of the model rats as observation indicators,the applicability of the model rats to the intervention of gastric perfusion was and intraorbital electroacupuncture evaluated.Results The success rate after molding 24 h:In the sphenopalatine foramen approach group was 92.31%(12/13);In the skull base approach group was 34.29%(12/35).Survival rate:7 d after gavage:In the sphenopalatine foramen approach group,6 patients survived,with a survival rate of 100.00%(6/6).Four patients survived in the skull base approach group,with a survival rate of 66.67%(4/6).7 days after orbital electroacupuncture:Five patients survived in the sphenopalatine foramen approach group(83.33%,5/6).Three patients survived in the skull base approach group,with a survival rate of 50.00%(3/6).Survival state of rats(0-20 points,the smaller the score,the better):24 h after modeling,the status score of sphenopalatine foramina approach group was 4.11±0.90,and that of skull base approach group was 12.39±1.378.After 7 days of intragastric administration,the score of sphenopalatine foramina approach group was 2.50±1.05,and the score of skull base approach group was 14.50±0.58.The score of sphenopalatine foramina approach group was 2.00±1.22 and the score of skull base approach group was 15.33±0.58 after 7 days of intraorbital electroacupuncture intervention.The success rate,survival rate and survival state of rats in sphenopalatine foramina approach group were better than those in skull base approach group 24 h after modeling(P<0.05);The survival rate and survival state of rats in sphenopalatine foramina approach group were better than those in skull base approach group 7 days after gavage and orbital electroacupuncture intervention(P<0.05).Conclusion The model of oculomotor nerve injury prepared by sphenopalatine foramina approach is more suitable for the basic research of nerve repair after the intervention of gastric gavage and orbital electroacupuncture.The model rats with oculomotor nerve injury prepared by the base approach are more suitable for the basic research after the injury of the intracranial segment of the oculomotor nerve.

Objective:Hypoxia is an important cause of chemotherapy resistance in gastric cancer.However,little is known about the growth of gastric cancer under purely hypoxia conditions.This study aims to study the effect of hypoxia on the growth patterns of gastric cancer cells and explore the response of gastric cancer cells to the chemotherapeutic drug 5-fluorouracil(5-FU)in a hypoxic environment. Methods:Gastric cancer cells MKN45 were cultured under 1%oxygen hypoxia and conventional air conditions.An intervention group with the addition of the chemotherapeutic drug 5-FU was also established.The proliferation and apoptosis of gastric cancer cells under different oxygen conditions and intervention groups were detected using the cell counting kit-8(CCK-8)method,JC-1 mitochondrial membrane potential assay,and Annexin-V/PI double staining method.Cell cycle changes were detected by flow cytometry,and mitochondrial changes were detected using electron microscopy. Results:In the absence of 5-FU intervention,compared with the normoxia group,the hypoxia group showed higher rates of early and late apoptosis and higher cell death rates as indicated by the JC-1 mitochondrial membrane potential assay,Annexin-V/PI double staining,and CCK-8 results.Flow cytometry results showed that the cell cycle was arrested in the G0/G1 phase without progression.Electron microscopy revealed more severe mitochondrial destruction.However,with 5-FU intervention,the hypoxia group showed lower apoptosis rates,more cell cycle progression,and less mitochondrial destruction compared with the normoxia group. Conclusion:Hypoxic environments promote apoptosis and even death in gastric cancer cells,but hypoxia counteracts the efficacy of the chemotherapeutic drug 5-FU,which may contribute to 5-FU chemotherapy resistance.

Berberine is a commonly used traditional Chinese medicine,which has the antimicrobial and anti-inflammatory properties.Ongoing investigations have identified berberine as an effective medicine for systemic diseases,such as cardiovascular diseases,diabe-tes mellitus and neurological disorders.At the same time,there exists a close relationship between oral microbiota and these systemic diseases.This review focuses on the relationship between berberine,oral microbiota and systemic diseases,offering new insights for the treatment of systemic diseases.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective:To investigate the effect of spinopelvic sagittal alignment and lordosis distribution index on adjacent segment degeneration (ASD) after short-segment lumbar interbody fusion.Methods:A total of 234 patients who underwent posterior lumbar interbody fusion due to lumbar degenerative diseases in the Affiliated Changzhou Second People's Hospital of Nanjing Medical University and Affiliated Drum Tower Hospital, Medical School of Nanjing University from January 2009 to January 2019 were retrospectively analyzed. There were 102 males and 132 females, aged 60.1±10.0 years (range, 41-78 years). The patients were divided into ASD group and non-ASD group according to whether ASD occurred after operation. The general data, pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), distal lordosis (DL), segmental lordosis (SL), lordosis distribution index (LDI) and sagittal vertical axis (SVA) before and after operation were compared between the two groups. Independent risk factors for the occurrence of ASD after lumbar fusion were analyzed using binary logistic regression. The receiver operating characteristic curve (ROC) was plotted, and the area under the curve was calculated for each independent risk factor.Results:All patients successfully completed the operation and were followed up for 70.6±11.9 months (range, 60-121 months). Among the 234 patients, 116 patients developed ASD after operation. Age ( t=2.697, P=0.008), fusion segment (χ 2=16.439, P<0.001), preoperative PT ( t=2.268, P=0.024), preoperative LL ( t=2.042, P=0.042), preoperative DL ( t=2.724, P=0.007), postoperative DL ( t=3.104, P=0.002), postoperative LDI ( t=2.063, P=0.040) and the difference of SVA before and after operation ( Z=2.001, P=0.045) were statistically significant. Binary logistic regression analysis showed that LDI decreased ( OR=0.971, P=0.002), two-level fusion ( OR=3.477, P<0.001), and increased SVA difference before and after operation ( OR=0.992, P=0.039) were independent risk factors for ASD after lumbar fusion. The ROC curve showed that the area under the curve and 95% CI of the number of fusion segments, postoperative LDI, and the difference of SVA before and after operation were 0.633 (0.561, 0.704), 0.583 (0.510, 0.656) and 0.576 (0.502, 0.649), respectively. The area under the curve of the combined prediction model was 0.702, and the prediction value was medium. Conclusion:Two-level fusion, decreased LDI after operation, and increased SVA difference before and after operation are independent risk factors for ASD after lumbar fusion, and the combined prediction of the three has good predictive efficiency.

Objective To observe the value of vector flow mapping(VFM)technique for assessing changes of left ventricular diastolic function in ovarian cancer(OC)patients who underwent postoperative chemotherapy.Methods Totally 37 OC patients who received postoperative chemotherapy were prospectively enrolled in chemotherapy group,while 40 healthy adults were taken as controls(control group).Routine echocardiography and VFM were performed for chemotherapy group before chemotherapy,after 3 and 6 cycles of chemotherapy,also for controls at enrollment,and comparison was performed between groups before chemotherapy,as well as among different time points within chemotherapy group,and the correlations of VFM results with hemoglobin and routine echocardiographic results in chemotherapy group were analyzed.Results No significant difference of age,body mass,body surface area(BSA),nor hemoglobin level,routine echocardiographic and VFM results before chemotherapy was found between groups(all P＞0.05).With the process of chemotherapy,hemoglobin level gradually decreased,the isovolumic relaxation period(IR),atrial systole period(AS)intraventricular pressure difference(IVPD)and intraventricular pressure gradient(IVPG)of the left ventricle gradually increased(adjusted P＜0.05),whereas routine echocardiography only showed that the left atrial volume index(LAVI)and the ratio of early mitral inflow velocity and the mean mitral annular early diastolic velocity(E/e')increased after 6 cycles of chemotherapy compared with those pre-chemotherapy(adjusted P＜0.05).In chemotherapy group,VFM results in all diastolic subphases were strongly correlated with hemoglobin levels(|r|=0.718 to 0.836,all P＜0.05),weakly to moderately correlated with LAVI(|r|=0.375 to 0.525,all P＜0.05)and moderately correlated with E/e'(|r|=0.424 to 0.537,all P＜0.05).Conclusion The diastolic function of left ventricle was probably damaged in early stage after postoperative chemotherapy in OC patients.VFM might detect slight changes of early diastolic function of left ventricle more sensitively than routine echocardiography.