⁶⁰Co-γ ray irradiation has the unique advantages of high efficiency， strong penetration， operation at room temperature and no residue， which has been widely used in the sterilization of Chinese medicinal materials， decoction pieces， Chinese patent medicine. However， the irradiation effect may cause changes in the content of chemical components in Chinese materia medica or the emergence of new radiolysis products， leading to reduced efficacy and uncontrollable safety risks. This paper reviewed the relevant literature at home and abroad， summarized the effect of irradiation sterilization on various types of chemical compositions of Chinese medicinal materials and their preparations， and analyzed and explored the rule of change. The results showed that the content changes of various chemical components in Chinese materia medica after ⁶⁰Co-γ ray irradiation sterilization varied. The contents of most flavonoids， terpenoids， phenylpropanoids and quinones decreased after irradiation， and the degree of decrease increased with the elevated irradiation dose. The contents of lignans， alkaloids， isoflavones and some terpenoids did not change significantly before and after irradiation， while the content changes of triterpenoid saponins， dihydroflavonols， chalcones， sugars and glycosides after irradiation were not yet uniform. Therefore， it is recommended to pay attention to the compositional changes of irradiated Chinese medicines， strengthen the research on the standards of irradiated Chinese medicines， and standardize the irradiation and sterilization of Chinese medicines in order to promote the healthy and rational application of irradiated Chinese medicines.

Objective:To investigate whether ultra-high dose rate (FLASH) irradiation can reduce radiation-induced intestinal injuries of mice compared to conventional dose rate (CONV) irradiation.Methods:Both FLASH and CONV irradiation were delivered with electron beam, with dose rates of 750 Gy/s and 0.5G y/s, respectively. A total of 105 mice were randomly divided into groups using a simple randomization method. Twenty-one mice were selected for weight observation, 7 mice in each group. After 9 Gy FLASH and CONV irradiation on the abdomen, the weight changes of mice were measured every other day, and compared among three groups. Twenty-four mice were selected for pathological examination including 5 mice in the control group. Three-and-a-half-day days after 12 Gy FLASH ( n=10) and CONV irradiation ( n=9) on the abdomen, the intestines of the mice were taken. Pathological sections were stained with hematoxylin-eosin (HE) to compare the number and percentage of regenerated crypts of the small intestine between two groups. After 12 Gy FLASH ( n=10) and CONV irradiation ( n=10) on the abdomen, the survival of 20 mice was observed. After FLASH using 4.5 Gy×2 times ( n=10) and CONV irradiation at 9 Gy×1 time ( n=10) on the abdomen, the weight changes were observed. After FLASH using 6 Gy×2 times ( n=10) and CONV irradiation at 12 Gy×1 time ( n=10) on the abdomen, the survival of mice was observed. The time interval between two irradiation was 1 min. EBT3 film was employed to monitor the actual exposure dose of the mice. The variables conforming to normal distribution were expressed by Mean±SD. Inter group comparison was performed by independent t-test. The survival of mice among different groups was compared by log-rank test. Results:After 9 Gy of abdominal irradiation, the mean weight of mice in the FLASH group was significantly higher than that in the CONV group. The weight of mice in the FLASH and CONV groups was (19.8±0.8) g and (18.0±1.8)g ( P=0.036) at 7 days after irradiation, (22.0±1.0)g and (21.2±0.5)g ( P=0.075) at 15 days after irradiation, and (24.2±1.4)g and (22.0±1.2)g ( P=0.012) at 25 days after irradiation, respectively. After 12 Gy irradiation, the mean survival of mice in FLASH and CONV groups was 4 days and 4.7 days ( P=0.029). After 12 Gy total abdominal irradiation, the mean number of intestinal regenerative crypts in the FLASH and CONV groups was 2.9/mm and 1.2/mm ( P=0.041), and the percentage of intestinal regenerative crypts was 34.1% and 14.1%, respectively. The survival of mice irradiated by FLASH using 6 Gy×2 times was longer compared with that of mice after CONV irradiation at 12 Gy×1 time. The weight of mice after 4.5 Gy×2 times irradiation was higher than that of mice after CONV irradiation at 9 Gy×1 time. Conclusion:Weight, survival and the number of intestinal regenerative crypts in the FLASH group are higher than those in the CONV group after irradiation, indicating that radiation-induced intestinal injury caused by FLASH irradiation is slighter than that of CONV irradiation.

Fibroblasts are stromal cells widely distributed in tissues and organs throughout the body.Fibroblasts are involved in the synthesis and remodelling of the extracellular matrix.Fibroblasts participate in physiopathological processes such as tissue damage repair,inflammatory responses and immune regulation.Large numbers of activated fibroblasts have been found in fibrosis,autoimmune diseases and tumor lesions.Activated fibroblasts participate in tissue fibrosis and influence the tumor microenvi-ronment mainly by secreting collagen and fibronectin.They also secrete a variety of inflammatory and growth factors that play an immunomodulatory role in autoimmunity and tumors.In recent years,it has been found that modulating fibroblast activation can effectively delay the development of these diseases,and that targeting fibroblast activation biomarkers can assess the development and treatment of these diseases.Therefore,the use of fibroblast-targeted drugs and therapeutic tools is expected to achieve new breakthroughs in the clinical management of fibrosis,autoimmune diseases and tumors.

In order to standardize the clinical diagnosis and treatment of upper airway cough syndrome (UACS) for children in China, Dongzhimen Hospital of Beijing University of Chinese Medicine and Affiliated Hospital of Liaoning University of Traditional Chinese Medicine initiated the development of this Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Children with Upper Airway cough Syndrome based on evidence-based medical evidence. This guideline will process registration, write a plan, and develop relevant processes and writing norms, develop and publish official documents. This plan mainly introduces the scope of the guidelines, the purpose and significance, the composition of the guidelines working group, the management of conflicts of interest, the collection, selection and determination of clinical problems, the retrieval, screening and rating of evidence, and the consensus of recommendations. Registration information: This study has been registered in the international practice guidelines registry platform with the registration code of PREPARE-2023CN087.

Objective To investigate the relationship between serum lipid profiles and colorectal adenomas,and to benefit the prevention of colorectal cancer.Methods This study retrospectively analyzes the serum lipid profiles and clinical parameters of 2,960 patients who were diagnosed with colorectal adenomas,and 3,156 individuals without colorectal adenomas in Meizhou People's Hospital from May 2018 to May 2020.The association between serum lipid profiles and colorectal adenoma was evaluated by Logistic regression analysis.Results It was observed that the serum levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and apoliprotein B(ApoB)were significantly elevated in patients with colorectal adenomas.Dyslipidemia was more prevalent in adenoma cases than in controls.The Logistic regression analysis suggested that serum TC and TG levels were positively associated with the occurrence of colorectal adenomas.Conclusion Elevated serum TG and TC levels are independent risk factors for adenoma,and adenoma patients with elevated serum TG and TC levels may be more likely to develop high-risk adenoma.

Acute ischemic stroke (AIS) is a kind of central nervous system disease that seriously threatens human health and life. Current treatment for AIS is mainly reperfusion. However, the time-sensitive of reperfusion limits its clinical application, and a considerable part of patients within the time window cannot achieve the expected effect after reperfusion; related complications of reperfusion have not been completely solved. So far, some clinical trials have confirmed that neuroprotectants are useful supplements and adjuncts to reperfusion. This paper reviews the recent advance in neuroprotectants combined with reperfusion in AIS to provide references for AIS treatment.

Objective To study the clinical efficacy of using bronchoalveolar lavage in severe lobar pneumonia and to analyze the high-risk factors affecting the duration of the disease.Methods The clinical data of children with severe lobar pneumonia diagnosed in the Department of Pediatrics,the First Affiliated Hospital of Shihezi University from January 2018 to January 2022 were retrospectively collected,and the children in the lavage group and the control group were matched 1:1 according to whether bronchoalveolar lavage was performed using the propensityscore matching(PSM)method to compare the therapeutic effects of the two groups.At the same time,the children in the lavage group were divided into the long-duration group and the short-duration group according to whether the duration of the disease was more than 2 weeks,and the reasons for the difference in the duration of the disease between the two groups were analyzed.Results ① After treatment,the children in the lavage group had cough relief time,fever reduction time,lung rales disappearance time,lung imaging manifestations reduction time,white blood cell(WBC),neutrophil to lymphocyte ratio neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP),erythrocytes sedimentation rate(ESR),and procalcitonin(PCT)were all lower than those in the control group,and the differences were statistically significant(P<0.05).② In the lavage group,the CRP,lactate dehydrogenase(LDH),and fever peak value of children in the long-course group were significantly higher;The proportions of multi-pulmonary lobe infection,combined pleural effusion,and multiple pathogen infections were significantly higher than those in the short-course group.The difference was statistically significant among disease course groups(P<0.05).③ Two-category Logistic and receiver operating characteristic curve(ROC curve)analysis showed that LDH and CRP were independent risk factors for the disease duration in children in the lavage group>2 weeks,and the optimal critical values of LDH and CRP for predicting a disease duration of>2 weeks in children with severe lobar pneumonia were 333U/L and 32.6mg/L,respectively.Conclusion ① Bronchoalveolar lavage can shorten the treatment time of children with lobar pneumonia,speed up the recovery of inflammation,and significantly improve the efficacy.② Multiple pathogenic mixed infections,concurrent pleural effusion,LDH≥333 U/L,and CRP≥32.6 mg/L are independent risk factors for the disease duration>2 weeks after alveolar lavage in children with lobar pneumonia.We need to be alert to the possibility of prolonged disease course.

ObjectiveTo investigate the pathogenic spectrum and molecular characteristics of infectious diarrhea among children in Putuo District of Shanghai from 2018 to 2023， and to provide scientific basis for the prevention and control of infectious diarrhea in children. MethodsFecal samples from the cases visited sentinel hospitals for children’s diarrheal disease in Putuo District， Shanghai， were collected from January 2018 to December 2023. A total of 11 species of bacteria were isolated and cultured， and 5 species of viruses were detected by real-time fluorescent polymerase chain reaction （PCR）. The molecular typing of some positive strains was analyzed by the standard pulsed-field gel electrophoresis （PFGE） method. The polymerase-capsid protein linkage region of some norovirus-positive samples was amplified by reverse transcription PCR， and was sequenced and analyzed by bioinformatics software. The Chi-square test and Fisher’s exact probability test were used to compare the pathogen-positive rates in 2018‒2019 and 2020‒2023. ResultsOf the 707 cases of children with infectious diarrhea， the total positive rate was 47.67%， with a single bacterial positivity rate of 16.27%， a single viral positivity rate of 22.63%， and a mixed positivity rate of 8.77%， respectively. The dominant pathogens were rotavirus （10.75%）， norovirus （10.33%）， enteropathogenic Escherichia coli （8.06%）， Salmonella （6.36%）， enteroaggregative Escherichia coli （5.52%）， and Campylobacter （5.23%）. Bacterial infections were predominant in summer and fall， and viral infections were predominant in winter and spring. The total positive rate decreased in 2020‒2023 compared with that of 2018‒2019 （χ²=5.753，P<0.05）. Thirty-seven strains of Salmonella， 81 strains of diarrheagenic Escherichia coli， and 19 strains of Campylobacter were completed for the molecular typing analysis by PFGE， which were classified into 28， 80 and 18 banding types， respectively， with a wide range of banding similarity. Nineteen copies of norovirus GⅡ group gene sequences were analyzed and classified into 5 genotypes， which were mainly GⅡ.Pe-GⅡ.4 and GⅡ.P16-GⅡ.2 types. ConclusionRotavirus， norovirus， diarrheagenic Escherichia coli， Salmonella， and Campylobacter are the dominant pathogens of infectious diarrhea in children in Putuo District of Shanghai. The pathogen spectrum shows a trend of seasonal epidemic characteristics， with a diversity of molecular characteristics of some pathogens. Surveillance and monitoring on molecular characteristics of the pathogens of infectious diarrhea in children should be strengthened in different seasons， so as to provide a laboratory basis for the prevention and control of infectious diarrhea.

ObjectiveTo simulate the microstructure and mechanical properties of tendon tissue and promote its regeneration and repair, electrospinning technology was used to prepare L-polylactic acid (PLLA) fiber membranes loaded with different nano zinc oxide contents and with oriented structures. Physical and chemical characterization and biological performance evaluation were carried out to explore their effects on tendon cell proliferation and differentiation. MethodsPreparation of PLLA fiber scaffolds and PLLA/ZnO fiber scaffolds containing different mass fractions of nano ZnO was performed using electrospinning technology. The physicochemical properties of the scaffold were characterized by scanning electron microscopy, mechanical stretching, and EDS spectroscopy. The scaffold was co-cultured with mouse tendon cells to detect its biocompatibility and regulatory effects on cell differentiation behavior. ResultsThe fiber scaffolds were arranged in an oriented manner, and zinc elements were uniformly distributed in the fibers. The tensile strength and Young’s modulus of PLLA/0.1%ZnO fiber scaffolds were significantly higher than PLLA fiber scaffolds. The number of cells on the surface of PLLA/0.1%ZnO fiber scaffold was significantly higher than that of the PLLA group, and the activity was better; mouse tendon cells exhibit directional adhesion and growth along the fiber arrangement direction. ConclusionThe oriented PLLA/0.1%ZnO fiber scaffold had excellent physicochemical properties, which can significantly promote the oriented growth, proliferation and differentiation of tendon cells. It is expected to be used for tendon tissue regeneration and repair in the future.

Background Fine particulate matter (PM_2.5) in ambient air is an important carrier of heavy metals and polycyclic aromatic hydrocarbons (PAHs), and long-term inhalation of heavy metals and PAHs poses a potential threat to human health. Objective To analyze the ambient PM_2.5 concentrations and the distribution characteristics and sources of heavy metals and PAHs in PM_2.5 in an urban area of Taizhou City, aiming to provide basic data and a scientific basis for local air pollution management and population health prevention. Methods From 9am to 8pm on the 10th to 16th of each month from 2017 to 2022 (23 h·d⁻¹), a monitoring point was set up on the top floor of a building in the main urban area of Taizhou to collect PM_2.5 samples (sampling flow rate: 2.3 m³·h⁻¹) and measure its concentration. The characteristics of 12 heavy metals and 16 priority PAHs in PM_2.5 were analyzed. The pollution sources of heavy metals and PAHs were determined by enrichment factor method and isomer characteristic ratio method, respectively. Results From 2017 to 2022, the average daily concentration of PM_2.5 in this urban area ranged from 4 to 141 μg·m⁻³, and the median annual concentrations were lower than the national secondary standard limit. The seasonal concentration of PM_2.5 was as follows: winter>spring>summer and autumn, and the difference was statistically significant (H=134.077, P<0.01). The concentration of PM_2.5 in 2017.1 to 2020.1 was higher than that in 2020.2 to 2022.12 (Z=−3.989, P<0.01). The main heavy metal pollutants in this area were manganese (Mn), lead (Pb), arsenic (As), nickel (Ni), and chromium (Cr). Except for beryllium (Be) and mercury (Hg), the concentrations of other heavy metals had seasonal differences (P<0.01), higher in winter and spring than in summer and autumn. Except for manganese (Mn) and arsenic (As), the concentrations of other heavy metals were higher from 2017.1 to 2020.1 than from 2020.2 to 2022.12, and the difference was statistically significant (P<0.05). The results of enrichment factor indicated anthropogenic pollution sources of antimony (Sb), cadmium (Cd), and selenium (Se). The average daily concentration of PAHs ranged from 0.88 to 24.56 ng·m⁻³, with a seasonal trend of winter>spring>autumn>summer, and the difference was statistically significant (H=231.387, P<0.01). Among the 16 PAHs, the top pollutants were benzo [b] fluoranthene (BbF) (25.36%), indene [1,2,3-c,d] pyrene (IcdP) (11.22%), and benzo [g,h,i] perylene (BghiP) (9.02%). The results of characteristic ratio method showed that the 16 PAHs pollutants were produced by a combined action of gasoline buring, coal burning, and biomass burning. Conclusion In selected urban area of Taizhou City, the concentrations of PM_2.5, heavy metals, and PAHs all show a downward trend year by year at a relatively low level, and obvious seasonal distributions which are higher in winter and spring. Man-made pollution is the main source of heavy metals, and automobile exhaust emissions, industrial coal burning, and waste incineration may be the main sources of PAHs.