OBJECTIVE To analyze the chemical constituents from classical prescription Xiehuang San(XHS)standard decoc-tion by UPLC-Q-TOF-MS technology,and classify the chemical composition and analyze the representative components.METHODS Acquity HSS T3 column(2.1 mm×100 mm,1.8 μm)was used as the chromatographic column,with 0.1%formic acid solution-0.1%formic acid acetonitrile as the mobile phase for gradient elution.The volume flow rate was 0.4 mL·min-1 and the column tem-perature was 40℃.Mass spectrometry data of XHS were collected in positive and negative ion modes.The chemical constituents from classical prescription XHS were analyzed and identified by Masslynx 4.1 software comparison with reference materials,mass spectrome-try data analysis and reference to relevant literature.RESULTS A total of 107 compounds were analyzed and identified from XHS,including 45 flavonoids,27 triterpenoids,11 monoterpenoids,10 phenylpropanoids,6 chromogenic ketones,5 alkaloids and 3 other other compounds.CONCLUSION The study provides an experimental basis for the further research on the substance basis and qual-ity control of XHS.

Objective:To investigate the expression of DARS2 and its clinical significance in colorectal cancer.Methods:In this study, bioinformatics tools, especially gene expression profile interactive analysis 2 (GEPIA2), were used to conduct an in-depth analysis of DARS2 expression in colorectal cancer tissues. Immunohistochemical staining was carried out in 108 colorectal cancer specimens and 30 normal colorectal tissues obtained from the First Affiliated Hospital of Nanchang University, Nanchang, China. Colorectal cancer cell lines (HCT116 and SW480) were transfected with small interfering RNA (siRNA) and DARS2 overexpression plasmid to examine the effects of DARS2 knockdown and overexpression on cell function. To assess the effects on cell function, CCK8 and transwell migration assays were used to assess proliferation and cell motility, respectively. Additionally, protein immunoblotting was employed to scrutinize the expression of proteins associated with the epithelial-mesenchymal transition of colorectal cancer cells.Results:DARS2 exhibited a pronounced upregulation in expression within colorectal cancer tissues compared to their normal epithelial counterparts. Furthermore, DARS2 expression was higher in colorectal cancer of stage Ⅲ-Ⅳ than those of stage Ⅰ-Ⅱ, exhibiting a significant correlation with N staging, M staging, and pathological staging ( P<0.05). Kaplan-Meier analyses showed a decreased overall survival rate in colorectal cancer with DARS2 expression compared to those without DARS2 expression ( P<0.05). In the siRNA transfection group, there was a significant reduction in cell proliferation and migration ( P<0.01 and P<0.05, respectively). Conversely, the transfection of DARS2 overexpression plasmids substantially increased both cell proliferation and migration ( P<0.05). Additionally, immunoblotting revealed that DARS2 knockdown led to an upregulation of E-cadherin expression and a downregulation of N-cadherin and vimentin expression. In contrast, DARS2 overexpression resulted in increased N-cadherin and vimentin expression, coupled with reduction in E-cadherin expression. Conclusions:There is a strong association between DARS2 expression and colorectal cancer progression. Silencing DARS2 inhibits cell proliferation and migration, exerting a discernible influence on the epithelial-mesenchymal transition process.

A 26-year-old female patient was admitted to the hospital with recurrent infection of the incision after resection of a back sebaceous cyst,and the pus culture showed Mycobacterium abscessus.Clinical pharmacists reviewed relevant guidelines and literature,analyzed and summarized drug selection,drug resistance,adverse drug reactions and coping strategies,sequential treatment plans and treatment courses,and assist physicians in formulating individualised anti-infective treatment plans.Initially imipenem,amikacin and azithromycin were given according to bacterial culture results.Secondly,according to the results of drug sensitivity,they were changed to tigecycline,amikacin and clarithromycin.Finally,due to the adverse drug reaction of tigecycline and the recurrence of sinus in the patient,and considering the possibility of imipenem and clarithromycin resistance,the anti-infection regimen was adjusted in time to cefoxitin,amikacin and azithromycin.During treatment,the clinical pharmacist monitors drug effectiveness and adverse reactions,combining pharmacy expertise with clinical practice.After the treatment,the patient improved and was discharged.After discharge,azithromycin and omacycline were successively given to continue anti-infection treatment,and the incision on the patient's back basically healed through follow-up.Clinical pharmacist involvement in Mycobacterium abscessus anti-infective drug selection can provide individualised drug regimens for patients,ensure the safety and effectiveness of medication for patients,and provide references for the treatment and management of similar patients.

Objective:To investigate the safety, feasibility and accuracy of esophageal sponge cytology in esophageal carcinoma screening in high-incidence districts.Methods:Opportunistic screening for esophageal carcinoma was conducted on individuals aged 40-75 years with high-risk factors for esophageal carcinoma and visited out-patient clinic in Lianshui People's Hospital from May 2021 to June 2022. A new esophageal cell collector independently developed in China was used for esophageal sponge cytology sampling followed by cytopathological analysis. Atypical squamous cells or more severe lesions were defined as positive esophageal sponge cytology. Then gastroscopy was performed, and all suspicious areas under the endoscopy were biopsied for histopathological examination. Gastroscopy, biopsy histopathology and esophageal sponge cytology were conducted blindly in pairs. Outcome measures included adverse reactions during sampling, subject tolerability (using a visual simulation score), sampling quality, and diagnostic efficacy of esophageal sponge cytology using gastroscopy plus biopsy histopathology as the gold standard.Results:A total of 1 590 patients completed the screening program. During esophageal sponge cytology sampling, no serious adverse events were observed, and the adverse reactions were mainly manifested as vomiting during sampling [0.31% (5/1 590)] and sore throat after sampling [2.45% (39/1 590)], all of which resolved spontaneously without further medical intervention. The majority of subjects [98.62% (1 568/1 590)] reported good tolerance during the procedure. After sampling, 1 526 (95.97%) subjects had completely expanded sponge material, meeting the standard of good sampling quality. The scanning analysis of the digital pathology system showed that the number of sampled cells in 1 590 subjects ranged (2.01-4.00)×10 6, with a median of 3.48×10 6 cells, which could meet the requirements for interpreting cytological results. Using the positive esophageal sponge cytology for the diagnosis of esophageal carcinoma including high-grade intraepithelial neoplasia, esophageal squamous cell carcinoma and adenocarcinoma of esophagogastric junction, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 98.57% (69/70), 91.51% (1 391/1 520), 34.85% (69/198), 99.93% (1 391/1 392), and 91.82% (1 460/1 590), respectively. Conclusion:Esophageal sponge cytology presents promising diagnostic efficacy for esophageal carcinoma screening, offering a simple, safe, convenient, and effective approach in high-incidence esophageal carcinoma regions.

Objective: This study explored the relationships among psychological stress, achievement motivation and psychological capital in college students to provide a reference for improving the level of psychological capital in college students. Methods: A multi stage stratified cluster sampling method was used to select 9 940 college students from ten universities in Anhui Province. The achievement motivation scale (AMS), psychological stress scale (SRQ-20) and psychological capital scale (PPQ) were applied. The moderating effect of the questionnaire was analyzed with χ 2 tests, Spearman rank correlation and stratified regression. Results: Statistical differences were found in psychological stress according to major, whether students leader, family economic status and whether students had left behind experience ( χ 2=15.50, 10.25, 28.61, 25.55, P <0.05). The rank correlation results indicated that psychological stress was negatively correlated with the pursuit of success ( r =-0.27) and four dimensions of self efficacy,optimism,hope and resilence in psychological capital ( r =-0.43, -0.41,-0.36,-0.45)( P <0.05), and was positively correlated with the avoidance of failure ( r =0.25, P <0.05). The stratified regression model indicated that psychological stress in the dimensions of college students achievement motivation (pursuit of success: β =0.02, Δ R 2=0.01, P <0.01; failure avoidance: β = 0.03 , Δ R 2=0.01, P <0.01) played a moderating role in the relationship between psychological capital and psychological capital. Conclusion Being female, senior students, low household economic status, and left behind experience are associated with more psychological stress among college students. Psychological stress is correlated with achievement motivation and psychological capital, and has a moderating effect on the relationship between achievement motivation and psychological capital.

Objective: To investigate the clinical characteristics during the perioperative period of pheochromocytoma in patients aged 60 years and over. Methods: Data of age, sex, tumor size, anesthesia time, intraoperative bleeding volume, intraoperative blood pressure, complications and hospitalization time from patients with pheochromocytoma in our hospital treated by the retroperitoneal laparoscopic adrenalectomy from January 2008 to October 2018 were retrospectively analyzed.The relationships of age with the intraoperative hemodynamic instability and postoperative complications were analyzed. Results: A total of 203 patients with pheochromocytoma met the inclusion criteria were enrolled.Age over 60 years(OR1.771, 95%CI=1.015-3.089, P=0.044)was an independent risk factor for intraoperative hemodynamic instability. Conclusions Laparoscopic retroperitoneal adrenalectomy is a safe surgical method for pheochromocytoma patients aged 60 years and over.For elderly patients with pheochromocytoma, especially those with a tumor diameter of more than 5 cm, special attention should be paid to the prevention of intraoperative hypertension crisis.

Objective To investigate the correlation of clinicopathological parameters and prognosis with serum and pancreatic cancer tissue klotho. Methods Immunohistochemistry EnVision two step method was used to assess klotho protein expression of a tissue microarray ( TMA) of 79 pairs of pancreatic tissue and normal surrounding tissue. The serum klotho levels in 39 pancreatic cancer patients and 39 healthy controls who had matched clinical data were measured by ELISA. The relationships between the expression of klotho and the clinicopathological features and survival were analyzed. Results Klotho expression positivity in pancreatic cancer tissue was significantly higher than that in adjacent normal tissues (59. 5％ vs 96. 3％);serum level of klotho was markedly higher in pancreatic cancer patients than that in control group [(670. 30 ± 82. 24)pg/ml vs (310.35 ± 34.65) pg/ml], and both the difference was statistically significant (P<0.001). Klotho expression was negatively associated with tumor clinical stage and lymph node metastasis (P<0. 05), and the expression of klotho did not correlate with patients' gender, age, tumor size, location, local invasion depth and the like. The median survival time in pancreatic cancer patients with positive klotho expression were longer than that in in pancreatic cancer patients with negative klotho expression [(48. 31 ± 6. 94) months vs (19. 50 ±6. 78)months], and the difference was statistically significant (P<0. 01). ROC analysis on serum klotho gave a cutoff value of 376. 51 pg/ml to diagnosis pancreatic cancer with a sensitivity of 84. 6％ and specificity of 87. 2％. Conclusions Klotho level in serum and tissue of pancreatic cancer patients was closely correlated with clinicopathological parameters and prognosis, which may be a potential biomarker for pancreatic cancer.

Objective To approach the spine MRI features and its possibility of etiology for refractory lower urinary tract symptoms(LUTS) in female patients.Methods We conducted prospectively a cross sectional description study of female patients with refractory LUTS during January 16 through March 27 in 2017 based on a urologist's outpatient work.The including criteria were adult female patients with refractory LUTS which defined as having LUTS more than three months and having poor response to behavior therapy and medication treatment.The excluding criteria were patients having evidence of infection,tumor,stone in urinary tract,any central nerve system diseases,or any other diseases may potentially producing LUTS.Data collected included patients demographic information,main complains,present disease features,disease history,physical examination,urine routine,urodynamic study and spine MRI.The characteristics of clinical manifestation,urodynamic study and spine MRI were analyzed.Results During the time span of study,totally 70 cases had been diagnosed as having refractory LUTS and had qualified data of clinical recordings,urodynamic study and spine MRI.Among these 70 cases,63 (90.9％) had storage phase symptoms,11 (15.7％) had voiding phase symptoms,8 (11.4％) had postmicturition symptoms,12 (17.1％) also had disorders in defecating,45 (64.3％) had pain in lower abdomen or pelvic region.69 cases (98.6％) had urodynamic disorders,33 (47.1％) had oversensitivity of bladder,12 (17.1％) had smaller bladder volume,16(22.9％) had detrusor overactivity,15 (21.4％) had bladder outlet obstruction,39(55.7％) had detrusor underactivity.69 cases(98.6％)had spine MRI abnormalities,54(77.1％) had sacral nerve lesions,49 (70.0％) had cervical lesions,48 (68.6％) had lumbar lesions,4 had thorathic lesions.Conclusions The present study revealed extraordinary high prevalence of abnormality in urodynamic parameters and spine MRI in female patients with refractory LUTS,which implies possibility that the refractory LUTS are caused by lesions in spinal nerve system.

OBJECTIVE:To compare the difference in the concentration determination of valproie acid (VPA) in human serum by LC-MS/MS and EMIT.METHODS:Both LC-MS/MS and EMIT methods were applied to determine the serum concentration of VPA in 144 inpatients or outpatients.The paired t-test,Pearson correlation analysis,Bland-Altman deviation chart and other methods were used to evaluate the difference in the results of concentration determination.RESULTS:The results of LC-MS/MS method was pos itively correlated with that of EMIT method (r=0.924,P＜0.05);the regression equation of them was cEMIT=0.920 7cLC.MS/MS-1.114 4 (r=0.924).Average serum concentrations of VPA determined by LC-MS/MS and EMIT were (49.9 ± 21.2) and (54.9 ± 21.3) μg/mL,with statistical significance (P＜0.05).The serum concentration of VPA determined by EMIT was higher than that by LC-MS/MS 8.3 μg/mL,95％ confidence interval was (-13.6,18.7).CONCLUSIONS:The serum concentration of VPA determined by LC-MS/MS and EMIT have high correlation.But the determination results still have certain difference,it is suggested to use same method for long term monitering.

Objective:To assess the effects of HEMA on the proliferation and migration of human dental pulp cells(hDPCs).Meth-ods:hDPCs were obtained using tissue explant culture technique in vitro,and then cells of the 3rd -5th passages were treated by differ-ent concentrations of HEMA for 24,48 and 72 h respectively.Cell proliferation was examined by MTT assay.Cell migration was ob-served by Transwell method.Results:The proliferation ability of hDPCs decreased when exposed to HEMA in both time and concentra-tion dependent manner(vs control,P <0.05).Cell proliferation at 24 h expossure was statistically higher than that at 48 h and 72 h(P<0.05).The migration of hDPCs was significantly reduced in HEMA groups at different concentrations(vs control,P <0.05).Con-clusion:HEMA inhibits the proliferation and migration of human dental pulp cells in vitro.