The chemical constituents in dried roots of Atractylodes macrocephala were investigated in this study. Through utilizing normal-phase silica gel and ODS column chromatography, TLC, and semi-preparative HPLC, 4 new sesquiterpenoids were purified from the ethyl acetate extract of A. macrocephala. By various spectroscopic techniques, such as 1D and 2D NMR, HR-ESI-MS, IR, UV, and CD, their structures were identified as atractylmacron A (1), 9β-hydroxyasterolide (2), atractylenolide H (3), atractylenolide J (4). Compound 1 possesses a rare 6/7 bicyclic skeleton.

Disorders of consciousness (DOC) are pathological conditions characterized by severely suppressed brain function and the persistent interruption or loss of consciousness. Accurate diagnosis and evaluation of DOC are prerequisites for precise treatment. Traditional assessment methods are primarily based on behavioral scales, which are inherently subjective and rely on observable behaviors. Moreover, traditional methods have a high misdiagnosis rate, particularly in distinguishing minimally conscious state (MCS) from vegetative state/unresponsive wakefulness syndrome (VS/UWS). This diagnostic uncertainty has driven the exploration of objective, reliable, and efficient assessment tools. Among these tools, electroencephalography (EEG) has garnered significant attention for its non-invasive nature, portability, and ability to capture real-time neurodynamics. This paper systematically reviews the application of EEG biomarkers in DOC assessment. These biomarkers are categorized into 3 main types: resting-state EEG features, task-related EEG features, and features derived from transcranial magnetic stimulation-EEG (TMS-EEG). Resting-state EEG biomarkers include features based on spectrum, microstates, nonlinear dynamics, and brain network metrics. These biomarkers provide baseline representations of brain activity in DOC patients. Studies have shown their ability to distinguish different levels of consciousness and predict clinical outcomes. However, because they are not task-specific, they are challenging to directly associate with specific brain functions or cognitive processes. Strengthening the correlation between resting-state EEG features and consciousness-related networks could offer more direct evidence for the pathophysiological mechanisms of DOC. Task-related EEG features include event-related potentials, event-related spectral modulations, and phase-related features. These features reveal the brain’s responses to external stimuli and provide dynamic information about residual cognitive functions, reflecting neurophysiological changes associated with specific cognitive, sensory, or behavioral tasks. Although these biomarkers demonstrate substantial value, their effectiveness rely on patient cooperation and task design. Developing experimental paradigms that are more effective at eliciting specific EEG features or creating composite paradigms capable of simultaneously inducing multiple features may more effectively capture the brain activity characteristics of DOC patients, thereby supporting clinical applications. TMS-EEG is a technique for probing the neurodynamics within thalamocortical networks without involving sensory, motor, or cognitive functions. Parameters such as the perturbational complexity index (PCI) have been proposed as reliable indicators of consciousness, providing objective quantification of cortical dynamics. However, despite its high sensitivity and objectivity compared to traditional EEG methods, TMS-EEG is constrained by physiological artifacts, operational complexity, and variability in stimulation parameters and targets across individuals. Future research should aim to standardize experimental protocols, optimize stimulation parameters, and develop automated analysis techniques to improve the feasibility of TMS-EEG in clinical applications. Our analysis suggests that no single EEG biomarker currently achieves an ideal balance between accuracy, robustness, and generalizability. Progress is constrained by inconsistencies in analysis methods, parameter settings, and experimental conditions. Additionally, the heterogeneity of DOC etiologies and dynamic changes in brain function add to the complexity of assessment. Future research should focus on the standardization of EEG biomarker research, integrating features from resting-state, task-related, and TMS-EEG paradigms to construct multimodal diagnostic models that enhance evaluation efficiency and accuracy. Multimodal data integration (e.g., combining EEG with functional near-infrared spectroscopy) and advancements in source localization algorithms can further improve the spatial precision of biomarkers. Leveraging machine learning and artificial intelligence technologies to develop intelligent diagnostic tools will accelerate the clinical adoption of EEG biomarkers in DOC diagnosis and prognosis, allowing for more precise evaluations of consciousness states and personalized treatment strategies.

Humans ; Vascular Stiffness ; Coal Mining ; Occupational Diseases/epidemiology* ; Risk Factors ; Coal ; Miners

Based on FangNet platform,the data of the prescriptions for the effective cases of post-stroke sequelae treated by national renowned Chinese medical practitioner LIU Mao-Cai were collected for the analysis of medication frequency of the prescribed drugs as well as their properties,flavors and meridian tropism.The medication rules of LIU Mao-Cai for treating post-stroke sequelae was summarized by analyzing the weight scale,co-occurrence and mutual exclusivity of the prescribed drugs and by drug-symptom association rule analysis and drug clustering analysis.The results showed that a total of 105 prescriptions involving 95 Chinese medicines were obtained.The drugs in the prescriptions were mainly warm in nature,sweet in flavor and had the meridian tropism of liver meridian.There were 17 driver herbs,and they were Astragali Radix,Gastrodiae Rhizoma,Corni Fructus,Codonopsis Radix,Eucommiae Cortex,Achyranthis Bidentatae Radix,Chuanxiong Rhizoma,Polygalae Radix,Curcumae Longae Rhizoma,Acori Tatarinowii Rhizoma,Ophiopogonis Radix,Atractylodis Macrocephalae Rhizoma,Salviae Miltiorrhizae Radix et Rhizoma,Poria,Uncariae Ramulus cum Uncis,Pinelliae Rhizoma Praeparatum,and Ligustri Lucidi Fructus.The results of drug co-occurrence analysis yielded 12 drug pairs such as Achyranthis Bidentatae Radix-Eucommiae Cortex,drug-symptom association rule analysis yielded 9 groups of drug-symptom association combinations such as Gastrodiae Rhizoma-dizziness,and cluster analysis yielded 4 drug combinations.The results indicated that the drugs for post-stroke sequelae treated by LIU Mao-Cai are mild in nature and mainly have the actions of supporting healthy-qi and replenishing the deficient,and Astragali Radix and Codonopsis Radix are often used to replenish the vital energy,and Corni Fructus,Achyranthis Bidentatae Radix and Eucommiae Cortex are usually used to tonify the liver and kidney.Moreover,simultaneous treatment of phlegm and blood stasis,and simultaneous application of purging and nourishing therapeutics are also stressed.

Objective To compare the prevention and control effects of binocular myopia after wearing orthokeratology lenses or glasses for correction in adolescents with low-to-moderate unilateral myopia.Methods The clinical data of 46 adolescents with unilateral myopia treated in First Affiliated Hospital of Army Medical University were retrospectively analyzed,the patients were divided into the orthokeratology lenses group and spectacles group according to the correction methods,with 23 cases in each group.The axial length(AL),changes in spherical diopter(SD)and anisometropia between the myopic eye and the control eye with orthokeratology lenses spectacles for unilateral myopia correction,and orthokeratology lenses for unilateral and binocular myopia were compared.Results There was no significant difference in baseline AL,SD or anisometropia between the two groups(P>0.05).One year after unilateral myopia correction,the increase of SD for the myopic eye in the orthokeratology lenses group was less than that in the spectacles group(P<0.05),and there was no significant difference in the AL elongation of myopic eyes between the two groups(P>0.05);the elongation of AL for the control eyes in the orthokeratology lenses group was more than that in the spectacles group;the increase of SD for the myopic eyes in the orthokeratology lens group was lower than that in the spectacles group(P<0.05),and there was no significant difference in the increase of SD for the control eyes between the two groups(P>0.05);the anisometropia of patients in the orthokeratology lenses group was less than that in the spectacles group(P<0.05).The biological parameters of the eyes before and after wearing orthokeratology lenses in the patients with monocular and binocular myopia in the orthokeratology lens group were compared,the elongation of AL for the myopic eyes with lens in one eye was less than that with lenses in both eyes(P<0.05),and the elongation of AL for the control eye was more than that with lenses in both eyes(P<0.05),the increases of SD in both myopic eyes and control eyes were more than those with lenses in both eyes(P<0.05),and the anisotropia was more than that with lenses in both eyes(P<0.05).Conclusion Orthokeratology lenses is better than spectacles in controlling the increase of myopia in low-to-moderate unilateral myopia,which can reduce anisometropia between eyes.However,the AL of the emmetropic eye increases rapidly during unilateral myopia correction by orthokeratology lenses,and the progression of binocular myopia can be significantly delayed after wearing orthokeratology lenses.

Objective:To develop a robotic digestive endoscope system (RDES) and to evaluate its feasibility, safety and control performance by experiments.Methods:The RDES was designed based on the master-slave control system, which consisted of 3 parts: the integrated endoscope, including a knob and button robotic control system integrated with a gastroscope; the robotic mechanical arm system, including the base and arm, as well as the endoscopic advance-retreat control device (force-feedback function was designed) and the endoscopic axial rotation control device; the control console, including a master manipulator and an image monitor. The operator sit far away from the endoscope and controlled the master manipulator to bend the end of the endoscope and to control advance, retract and rotation of the endoscope. The air supply, water supply, suction, figure fixing and motion scaling switching was realized by pressing buttons on the master manipulator. In the endoscopy experiments performed on live pigs, 5 physicians each were in the beginner and advanced groups. Each operator operated RDES and traditional endoscope (2 weeks interval) to perform porcine gastroscopy 6 times, comparing the examination time. In the experiment of endoscopic circle drawing on the inner wall of the simulated stomach model, each operator in the two groups operated RDES 1∶1 motion scaling, 5∶1 motion scaling and ordinary endoscope to complete endoscopic circle drawing 6 times, comparing the completion time, accuracy (i.e. trajectory deviation) and workload.Results:RDES was operated normally with good force feedback function. All porcine in vivo gastroscopies were successful, without mucosal injury, bleeding or perforation. In beginner and advanced groups, the examination time of both RDES and ordinary endoscopy tended to decrease as the number of operations increased, but the decrease in time was greater for operating RDES than for operating ordinary endoscope (beginner group P=0.033; advanced group P=0.023). In the beginner group, the operators operating RDES with 1∶1 motion scaling or 5∶1 motion scaling to complete endoscopic circle drawing had shorter completion time [1.68 (1.40, 2.17) min, 1.73 (1.47, 2.37) min VS 4.13 (2.27, 5.16) min, H=32.506, P<0.001], better trajectory deviation (0.50±0.11 mm, 0.46±0.11 mm VS 0.82±0.26 mm, F=38.999, P<0.001], and less workload [42.00 (30.00, 50.33) points, 43.33 (35.33, 54.00) points VS 52.67 (48.67, 63.33) points, H=20.056, P<0.001] than operating ordinary endoscope. In the advanced group, the operators operating RDES with 1∶1 or 5∶1 motion scaling to complete endoscopic circle drawing had longer completion time than operating ordinary endoscope [1.72 (1.37, 2.53) min, 1.57 (1.25, 2.58) min VS 1.15 (0.86, 1.58) min, H=13.233, P=0.001], but trajectory deviation [0.47 (0.13, 0.57) mm, 0.44 (0.39, 0.58) mm VS 0.52 (0.42, 0.59) mm, H=3.202, P=0.202] and workload (44.62±21.77 points, 41.24±12.57 points VS 44.71±17.92 points, F=0.369, P=0.693) were not different from those of the ordinary endoscope. Conclusion:The RDES enables remote control, greatly reducing the endoscopists' workload. Additionally, it gives full play to the cooperative motion function of the large and small endoscopic knobs, making the control more flexible. Finally, it increases motion scaling switching function to make the control of endoscope more flexible and more accurate. It is also easy for beginners to learn and master, and can shorten the training period. So it can provide the possibility of remote endoscopic control and fully automated robotic endoscope.

Objective To explore the efficacy of high tibial osteotomy(HTO)combined with medial meniscus centraliza-tion in knee osteoarthritis.Methods A total of 26 patients who underwent surgery from October 2018 to October 2020 were re-viewed.Among them,14 patients underwent high tibial osteotomy combined with arthroscopic meniscus centralization surgery were centralized group,including 8 males and 6 females,with an average age of(50.2±1.4)years old and follow-up time of(16.8±4.0)months.Twelve patients with high tibial osteotomy were in the control group,including 6 males and 6 females,with an average age of(50.9±1.8)years and follow-up time of(19.0±4.8)months.Operation time,the knee Lysholm score,knee 2000 IKDC score,MRI,femoral tibial angle(FTA),hip knee ankle angle(HKA),and intraoperative and postoperative compli-cations were recorded.Results All the incisions healed without any complication.The operation time in the centralized group was longer than that in the control group[(65.0±2.1)min vs(52.0±2.1)min,P＜0.05].The medial meniscus extrusion reduction value in the centralized group was significantly reduced compared with the control group[(2.8±1.4)mm vs(1.1±2.2)mm,P＜0.05].The FTA,HKA,knee Lyshlom score,and 2000 IKDC score between two groups were no significantly(P＞0.05).Postop-erative knee Lyshlom score and knee 2000 IKDC score improved in both groups(P＜0.05).Conclusion HTO combined with centralization of medial meniscus can improve the reduction of medial meniscus and improve knee function.The medium and long-term curative effect still needs long-term follow-up of more cases.

The membranous tube of sanjiao （三焦） is not only the path of the transport of fluid and qi， but the way of the invasion of pathogenic factors， therefore， it cooperates with the skin mucous membrane physically and influence on each other pathologically. It is believed that the core pathogenesis of chronic urticaria is pathogens intruding sanjiao， membrane collaterals acute spasm， and fluid and qi disturbance， of which defense qi insufficiency and pathogens intruding sanjiao initiates the disease， while struggle between healthy and pathogenic qi and membrane collaterals acute spasm is the intermediate stage， and disturbed fluid， qi and blood movement is the terminal stage. Following the core treatment principle of dredging sanjiao， the internal treatment is to open striae and interstices and dispel pathogens out using self-made Guben Shufeng Decoction（固本疏风汤）modifications， and the external treatment is to dredge and regulate membrane collaterals， move qi and fluid， and treat sanjiao simultaneously， commonly using cutting therapy on Danzhong （RN 17） to move qi and fluid， seal umbilical therapy on Shenque （RN 8） to supplement and nourish ying-wei （营卫）， and natural moxibustion on Xuehai （SP 10） to move blood and unblock collaterals.

OBJECTIVE To provide reference for improving the disease diagnosis related groups （DRG） payment reform， promoting refined hospital operation and management and rational drug use. METHODS Taking the orthopedic department of our hospital （the Third Affiliated Hospital of Anhui Medical University） as the research object， based on evidence-based medicine， a medication clinical pathway （hereinafter referred to as medication pathway） for DRG diseases in this department was constructed and implemented. All patients who met the DRG disease were included in the medication path management， and the patients in the same DRG disease group were treated with the same treatment method. Segmented regression model （SRM） was adopted to analyze the effects of medication pathway on the medical service capacity， efficiency and quality of our hospital. RESULTS During the implementation of medication pathway， significant decreases were observed in average length of hospital stay， cost per hospitalization， the proportion of medication expenses， medication cost per hospitalization and defined daily dose； the proportion of medical service revenue and the qualified rate of medical orders significantly increased （P＜0.05）. After the implementation of medication pathway， the average length of hospital stay and defined daily dose continued to decrease， and the qualified rate of medical orders also continued to significantly increase （P＜0.05）. CONCLUSIONS The implementation of medication pathway enhances the quality of medical services， improves operational efficiency， reduces medical expenses， and contributes to the development of a refined hospital management system.

ObjectiveTo investigate the effect of mucin 1 (MUC1) on the proliferation and apoptosis of nasopharyngeal carcinoma (NPC) and its regulatory mechanism. MethodsThe 60 NPC and paired para-cancer normal tissues were collected from October 2020 to July 2021 in Quanzhou First Hospital. The expression of MUC1 was measured by real-time quantitative PCR (qPCR) in the patients with PNC. The 5-8F and HNE1 cells were transfected with siRNA control (si-control) or siRNA targeting MUC1 (si-MUC1). Cell proliferation was analyzed by cell counting kit-8 and colony formation assay, and apoptosis was analyzed by flow cytometry analysis in the 5-8F and HNE1 cells. The qPCR and ELISA were executed to analyze the levels of TNF-α and IL-6. Western blot was performed to measure the expression of MUC1, NF-кB and apoptosis-related proteins (Bax and Bcl-2). ResultsThe expression of MUC1 was up-regulated in the NPC tissues, and NPC patients with the high MUC1 expression were inclined to EBV infection, growth and metastasis of NPC. Loss of MUC1 restrained malignant features, including the proliferation and apoptosis, downregulated the expression of p-IкB、p-P65 and Bcl-2 and upregulated the expression of Bax in the NPC cells. ConclusionDownregulation of MUC1 restrained biological characteristics of malignancy, including cell proliferation and apoptosis, by inactivating NF-κB signaling pathway in NPC.