Ischemia-reperfusion injury (IRI) can lead to organ dysfunction and tissue necrosis in the liver, kidney, myocardium and spinal cord, and there is currently a lack of effective treatment options. Human umbilical cord mesenchymal stem cell (HUC-MSC) and their derivatives have anti-inflammatory, anti-apoptotic, reactive oxygen species scavenging, mitochondrial and endothelial function improvement properties, and are ideal gene therapy carrier cells, providing new possibilities for the treatment of IRI in different organs. This article reviews the concept and mechanisms of IRI, the biological characteristics of HUC-MSC and their derivatives and their comparison with mesenchymal stem cells from other sources, and the mechanisms of HUC-MSC in treating IRI in different organs. It also summarizes and analyzes the advantages and disadvantages of HUC-MSC in protecting different organs from IRI, and prospects future research directions to explore more valuable research paths.

OBJECTIVE: Angelicae Sinensis Radix (ASR, Danggui in Chinese), Cistanches Herba (CH, Roucongrong in Chinese), Ginseng Radix et Rhizoma (PG, Renshen in Chinese), and Panacis Quinquefolii Radix (PQ, Xiyangshen in Chinese), widely used as medicine and dietary supplement around the world, are susceptible to fungal and mycotoxin contamination. In this study, we aim to analyze their fungal community by DNA metabarcoding. METHODS: A total of 12 root samples were collected from three main production areas in China. The samples were divided into four groups based on herb species, including ASR, CH, PG, and PQ groups. The fungal community on the surface of four root groups was investigated through DNA metabarcoding via targeting the internal transcribed spacer 2 region (ITS2). RESULTS: All the 12 samples were detected with fungal contamination. Rhizopus (13.04%-74.03%), Aspergillus (1.76%-23.92%), and Fusarium (0.26%-15.27%) were the predominant genera. Ten important fungi were identified at the species level, including two potential toxigenic fungi (Penicillium citrinum and P. oxalicum) and eight human pathogenic fungi (Alternaria infectoria, Candida sake, Hyphopichia burtonii, Malassezia globosa, M. restricta, Rhizopus arrhizus, Rhodotorula mucilaginosa, and Ochroconis tshawytschae). Fungal community in ASR and CH groups was significantly different from other groups, while fungal community in PG and PQ groups was relatively similar. CONCLUSION DNA metabarcoding revealed the fungal community in four important root herbs. This study provided an important reference for preventing root herbs against fungal and mycotoxin contamination.

Objective:To evaluate the consistency of the Chinese three-dimensional anterior visual field analysis system (Scansys), the anterior segment analyzer (Pentacam), the frequency-domain anterior segment optical coherence tomography system (CASIA SS-1000), and a new ultra-high frequency digital ultrasound scanning system (Arcscan Insight100) to measure central vault after implantable collamer lens (ICL) implantation in myopic eyes with crystalline lenses.Methods:A diagnostic test study was conducted.Fifty-six myopic patients (56 eyes) who underwent ICL V4c implantation from June to December 2019 were included.Scansys, Pentacam, CASIA and Arcscan were used to measure the central vault after surgery.The vault measurements were compared.Correlations between the measurements of the four instruments were analyzed using Pearson correlation analysis, and consistency comparisons were analyzed using the Bland-Altman method.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[13]). Written informed consent was obtained from each subject.Results:The central vault measurements by Scansys, Pentacam, CASIA and Arcscan were (481.8±191.6), (476.4±190.6), (619.3±207.5) and (534.0±221.2)μm, respectively, with a statistically significant overall difference ( F=143.301, P<0.001). The vault measurements by Scansys and Pentacam were significantly lower than CASIA and Arcscan, and Arcscan was lower than CASIA, with statistically significant differences (all at P<0.001). There were strong positive correlations in vault measurements between Arcscan and CASIA, Arcscan and Pentacam, Arcscan and Scansys, CASIA and Pentacam, CASIA and Scansys, Pentacam and Scansys ( r=0.982, 0.933, 0.931, 0.942, 0.941, 0.989; all at P<0.001). Intraclass correlation coefficients of vault measurements by Scansys, Pentacam, CASIA and Arcscan were 0.985, 0.975, 0.998, 0.992, respectively.The 95% limits of agreement of vault measurements differences were -170 to 0, 0 to 280, 0 to 280, -110 to 210, -100 to 220 μm, between CASIA and Arcscan, CASIA and Scansys, CASIA and Pentacam, Arcscan and Scansys, Arcscan and Pentacam, respectively, and the maximum absolute value of the difference was beyond the clinically acceptable range, showing poor agreement.The 95% limits of agreement of vault measurement difference was -60 to 50 μm between Scansys and Pentacam, showing a good agreement. Conclusions:The repeatability of the vault after ICL V4c implantation in myopic eyes measured by the four instruments is good.Among them, the vault measurements of Scansys and Pentacam are smaller, showing good consistency, and their results could be substituted for each other.The measurement of CASIA is the largest, followed by Arcscan, which have a large difference from each other, and their results can not be substituted for each other, which should be comprehensively analyzed with the actual situation in clinical work.

The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.How-ever,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive rela-tionship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met's anti-proliferative effects were blocked by AMPK inhibitor or YAP1 over-expression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.

Objective:To investigate age-related characteristics of gait parameters in the elderly.Methods:From February 2023 to August 2023, a convenient sampling method was used to investigate the elderly over 60 years old in communities in Beijing.General characteristics and anthropometric data were collected.Gait parameters of the subjects during normal speed walking were measured using a wearable gait analyzer.Comparisons were made of the basic characteristics, physical status and gait parameters in different age groups.Linear regression analysis was used to evaluate the changes of physical status and gait parameters with age, with the 60-69-year-old group as the baseline standard.Results:A total of 670 elderly people were included, including 324(48.4%)aged 60-69 years, 285(42.5%)aged 70-79 years, and 61(9.1%)aged ≥80 years.Linear regression analysis showed that after adjusting for confounding factors, with increasing age, skeletal muscle mass index(SMI)( β=-0.018, 95% CI: -0.029--0.007), calf circumference( β=-0.096, 95% CI: -0.142--0.051), upper limb flexibility( β=-0.200, 95%, 95% CI: -0.355--0.046), lower limb flexibility( β=-0.244, 95% CI: -0.377--0.111), grip strength( β=-0.397, 95% CI: -0.491--0.303), the Short Physical Performance Battery(SPPB)( β=-0.080, 95% CI: -0.100--0.060)decreased( P<0.05), and the gait parameter such as speed( β=-0.010, 95% CI: -0.014--0.007), cadence( β=-0.398, 95% CI: -0.634--0.162), step length/height( β=-0.002, 95% CI: -0.003--0.002), stride length( β=-0.009, 95% CI: -0.011--0.007), swing power( β=-0.009, 95% CI: -0.012--0.006), ground impact( β=-0.020, 95% CI: -0.026--0.014), foot fall( β=-0.050, 95% CI: -0.064--0.036), pre-swing angle( β=-0.545, 95% CI: -0.714--0.377)all decreased( P<0.05), while stride time( β=0.005, 95% CI: 0.001-0.009), single limb support time( β=1.566, 95% CI: 0.499-2.633), terminal double limb support time( β=0.609, 95% CI: 0.084-1.134), swing duration( β=1.288, 95% CI: 0.024-2.552), single step time( β=2.417, 95% CI: 0.462-4.372)and support phase time( β=1.935, 95% CI: 0.421-3.449)all increased( P<0.05). Conclusions:The walking ability tends to decline with age in older people in the community who walk at a normal walking speed.

OBJECTIVE To study pharmaceutical management provisions in the Evaluation Standards for Third-level Maternal and Child Health Care Hospitals in Hubei Province （2024 Edition） （hereinafter referred to as 2024 Edition of Hubei Maternal and Child Health Care Standards）. METHODS The formulation of pharmaceutical management clauses and management rules in the 2024 Edition of Hubei Maternal and Child Health Care Standards was elaborated and compared with the pharmaceutical management clauses in the Evaluation Standards for Third-level Maternal and Child Health Care Hospitals （2016 Edition） to find out their similarities and differences； the basis for the formulation of unique pharmaceutical management clauses was analyzed， so as to propose further improvement suggestions. RESULTS & CONCLUSIONS Compared with the Evaluation Standards for Third- level Maternal and Child Health Care Hospitals （2016 Edition）， the similarities in pharmaceutical management in the 2024 Edition of Hubei Maternal and Child Health Care Standards were mainly reflected in the relevant laws， regulations， rules and personnel requirements that should be followed， the full process management of drug procurement， reserve， storage and recall， drug dispensing and formulation management， etc. The unique provisions of the 2024 Edition of Hubei Maternal and Child Care Standards were mainly reflected in the establishment of children’s medication working group， the establishment of a list of children’s specific drugs， the development of surplus drug management system， and the management of off-label drug use， etc. The formulation of unique provisions for pharmaceutical management not only conformed to the newly released policy requirements in recent years， but also combined the characteristics and actual situation of maternal and child health care hospitals. 2024 Edition of Hubei Maternal and Child Health Care Standards should be further improved in terms of strengthening detail management and enhancing the rational application management of traditional Chinese medicine.

Pancreatic neuroendocrine neoplasm (pNEN) is highly heterogeneous, and the prognosis varies among tumors of different stages and grades. However, there is lacking high pro-gnostic predictors with sensitivity and specificity. Inflammation plays a pivotal role in the occurrence and development of different tumors, various inflammatory markers such as neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio are of great significance in the diagnosis, treat-ment, and prognosis of tumors. Several studies have demonstrated that inflammatory markers are associated with poor prognosis and can serve as predictive factors for tumor prognosis. The authors summarize recent advances in the researches focused on the prognostic value of inflamma-tory markers in pNEN, in order to provide novel insights for clinical decision-making of pNEN.

Objective To compare the impact of continuous profound neuromuscular blockade versus con-ventional neuromuscular blockade on postoperative shoulder pain in patients undergoing robot-assisted laparoscopic surgery during steep Trendelenburg position.Methods This study was a single-center,randomized,double-blind clinical trial.The inclusion criteria encompassed individuals aged between 18 and 80 years,with an American Society of Anesthesiologists status of Ⅰ or Ⅱ,and a body mass index ranging from 18 kg/m2 to 30 kg/m2.A total of one hundred patients were randomly assigned to either the deep neuromuscular blockade group(D group)or the conventional neuromuscular blockade group(C group),with equal distribution of fifty cases in each group.Rocuronium dosage was titrated to achieve post-tetanic count values of 1～2 and train-of-four stimulation levels of 1～2 during surgery for D and C groups respectively.At the end of surgery,sugammadex was administered for reversal of neuromuscular blockade.The primary endpoint assessed the incidence of postoperative shoulder pain within three days after surgery.Secondary endpoints included Leiden score evaluation during intraoperative period,number of additional neuromus-cular blockers required by the surgeon,recovery time for muscle relaxation postoperatively,nausea and vomiting scores during recovery phase,visual analog scale(VAS)scores in Post-Anesthesia Care Unit(PACU)as well as within three days after surgery,incidence rate for postoperative pulmonary complications,length of hospital stay duration and patient satisfaction score.Results The incidence of postoperative shoulder pain was significantly lower in group D compared to group C(D group 32%vs.C group 56%;P<0.05).However,there were no significant differences in postoperative shoulder pain VAS scores between the two groups(P>0.05).No significant differences were observed between the groups in terms of Leiden score,surgeon's requirement for additional neuromuscular blockers,nausea and vomiting in PACU,and VAS score(P>0.05).Group D exhibited better early postoperative activity pain scores than group C(P<0.05).There were no significant differences in VAS scores between the groups at other time points(P>0.05).Furthermore,there were no significant differences in the incidence of postoperative pulmonary complications,length of stay,and satisfaction scores between the two groups.Conclusion The imple-mentation of continuous deep neuromuscular blockade in patients undergoing robot-assisted laparoscopic surgery with steep Trendelenburg position can effectively mitigate the occurrence of postoperative shoulder pain.

Objective To explore the predictive value of serum fibrinogen(Fbg)and pentaxin-3(PTX3)levels for perioperative major adverse cardiovascular events(MACE)in elderly patients undergoing hip re-placement surgery.Methods A total of 201 patients who underwent hip replacement surgery in the Qilu Hos-pital of Shandong University,Dezhou Hospital(the hospital)from January 2022 to December 2022 were re-garded as the study group,and based on the presence or absence of MACE during the perioperative period,pa-tients were separated into the non MACE group(183 cases)and the MACE group(18 cases).Another 150 healthy examinees from the hospital were selected as the control group.Fully automated biochemical analyzer and enzyme linked immunosorbent assay(ELISA)were applied to detect serum Fbg and PTX3 levels in re-search objects.Multivariate Logistic regression was applied to analyze the influencing factors of perioperative MACE in elderly patients undergoing hip replacement surgery.Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of serum indicators for perioperative MACE in elderly patients un-dergoing hip replacement surgery.Results Compared with the control group,the serum Fbg and PTX3 levels in the study group were obviously increased,and the differences were statistically significant(P＜0.05).There were 18 cases who had MACE in elderly patients undergoing hip replacement surgery,with an incidence rate of 8.95％.Compared with the non MACE group,the serum Fbg and PTX3 levels in the MACE group were obviously increased,and the differences were statistically significant(P＜0.05).Elevated serum Fbg,PTX3,cardiac troponin I(cTnI),brain natriuretic peptide(BNP)levels,and decreased left ventricular ejection fraction were independent risk factors for perioperative MACE in elderly patients undergoing hip arthroplasty(P＜0.05).The area under the curve(AUC)of single and combined detection of serum Fbg and PTX3 levels for predicting the occurrence of perioperative MACE in elderly patients undergoing hip arthroplasty was 0.824,0.809,and 0.917,respectively.The combined prediction value of the two was higher than that of indi-vidual prediction(Z combination-Fbg=2.333,P=0.019;Z combination-PTX3=3.110,P=0.001).Conclusion The periop-erative serum Fbg and PTX3 levels in elderly patients undergoing hip replacement surgery are elevated,and the combination of the two has good predictive value for the occurrence of perioperative MACE.

Objective:To explore the medication law and ideas of national TCM master Zhang Lei in the treatment of patients with "stagnant pulse" based on data mining.Methods:Medical records of Professor Zhang's diagnosis and treatment of "stagnant pulse" disease from 1 April 2021 to 1 August 2022 in the Third Affiliated Hospital of Henan University of Chinese Medicine were collected. Excel 2019 and IBM SPSS Modeler 14.1 were used for frequency statistics, attribute analysis of Chinese materia medica, and association rule analysis. Clustering analysis of drugs was conducted using IBM SPSS Statistics 21, and conclusion and summary were performed based on Professor Zhang's clinical diagnosis and treatment experience.Results:Totally 213 medical records were collected, including 332 prescriptions. The main syndromes involved in patients were liver depression and qi stagnation, wood and soil stagnation, etc. The prescriptions involves a total of 243 kinds of Chinese materia medica. The top 5 kinds of Chinese materia medica in terms of medication frequency ranking were Glycyrrhizae Radix et Rhizoma (163 times), Bupleuri Radix (117 times), Pinelliae Rhizoma Praeparatum cum Alumine (110 times), Poria (108 times), Scutellariae Radix (104 times). Professor Zhang's medication for treating patients with "stagnant pulse" was mainly cold and warm; the tastes were mainly sweet, bitter, and pungent; the main meridians were spleen, lung, liver, stomach, and heart; the common medicinal pair was Bupleuri Radix-Angelicae Sinensis Radix, and the basic prescription included Bupleuri Radix, Pinelliae Rhizoma Praeparatum cum Alumine, Glycyrrhizae Radix et Rhizoma, Poria, Paeoniae Radix alba, Scutellariae Radix, Angelicae Sinensis Radix, Citri Reticulatae Pericarpium, Cyperi Rhizoma. Clustering analysis yielded four core categories: category 1 Jujubae Fructus, Zingiberis Rhizoma Recens, Codonopsis Radix, Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, Pinelliae Rhizoma Praeparatum cum Alumine, Scutellariae Radix, Coptidis Rhizoma, Ostreae Concha; category 2 Massa Medicata Fermentata, Astrctylodis Rhizoma, Chuanxiaong Rhizoma; category 3 Cyperi Rhizoma, Gardeniae Fructus, Bupleuri Radix, Menthae Haplocalycis Herba, Moutan Cortex, Paeoniae Radix alba, Angelicae Sinensis Radix, Poria, Citri Reticulatae Pericarpium, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma; category 4 Coicis Semen and Rhei Radix et Rhizoma.Conclusion:Professor Zhang's treatment for "stagnant pulse" is mainly to relieve depression, emphasize the balance of cold and heat, and also take care of the healthy qi to help dispel pathogenic factors and prevent transmission of changes.