Objective:To explore the development trajectory and influencing factors of self compassion in elderly patients with first stroke hemiplegia, in order to provide a theoretical basis for adopting more targeted intervention measures at different stages and early identification of elderly stroke hemiplegia patients with sustained low self compassion.Methods:This was a prospective longitudinal study. Convenience sampling method was used to select 247 elderly patients with first-episode stroke admitted to Sanya Central Hospital (Hainan Third People′s Hospital) from January to December 2022 and who were assessed as semi-disabled (Barthel index was 40-99 ) before discharge. The baseline data of patients were collected by general information questionnaire, self-compassion scale, simplified fear of disease progression scale and social support rating scale. The self-compassion level of patients was evaluated before discharge, 1 month after discharge, 3 months after discharge and 6 months after discharge.The latent class growth model (LCGM) was used to identify the development trajectory of self-compassion, and multivariate Logistic regression was used to analyze the predictors of different development trajectory categories.Results:Ultimately, 219 patients completed the entire investigation and follow-up. There were 132 males and 87 females, aged (69.74 ± 4.05) years old. The self-compassion level of patients before discharge, 1 month after discharge, 3 months after discharge and 6 months after discharge were (72.37 ± 11.53), (74.65 ± 13.26), (76.84 ± 12.11), (79.45 ± 13.64) points, and there were positive correlation between scores ( r values were 0.29-0.55, all P<0.05). Three different trajectory change categories were identified by LCGM, namely high-level stable group (29%,63/219), low-level delayed decline group (23%, 51/219), and medium-level elevated group (48%, 105/219).Multivariate Logistic regression analysis showed that per capita monthly income<2 000 yuan ( OR=2.857, 95% CI 1.093-7.464, P<0.05), high comorbidities ( OR=5.625, 95% CI 1.971-16.051, P<0.01), high fear of disease progression ( OR=1.167, 95% CI 1.080-1.261, P<0.01), and low social support ( OR=00.763, 95% CI 0.595-0.979, P<0.05) were more likely to enter the low-level delayed decline group, and high school education( OR=4.429, 95% CI 1.479-13.265, P<0.01) and high social support ( OR=1.120, 95% CI 1.043-1.202, P<0.01) were more likely to enter the middle-level rise group. Conclusions:The development trend of self-compassion in elderly stroke patients with semi-disability can be divided into three different trajectories: high-level stable group, low-level delayed decline group and medium-level elevated group. Low income level, more comorbidities and fear of disease progression are not conducive to the development of self-compassion after discharge, while high education level and social support are conducive to the improvement of self-compassion after discharge. Medical staff can formulate targeted intervention programs to improve patients′ self-compassion based on the above influencing factors.

Objective To analyze the changes in the amino acid composition and content of Eriobotryae folium in the twelve months,and to can provide a theoretical basis for the harvesting period and resource utilization of Eriobotryae folium.Methods The amino acid composition and content of Eriobotryae folium in different months were determined by high performance liquid chromatography with phenyl isothiocyanate pre-column derivation.SPSS22.0 software was used to analyze the statistical significance difference and data correlation.According to the ideal model proposed by the World Health Organization(WHO)and the Food and Agriculture Organization of the United Nations(FAO)and the amino acid ratio coefficient method proposed by Shengtao Zhu,the amino acids of Eriobotryae folium at different harvest periods were scored.Results There were seventeen kinds of amino acids,including seven essential amino acids(EAA),nine kinds of children's essential amino acids(CEAA),and nine kinds of medicinal amino acids in Eriobotryae folium at different harvesting periods.The seventeen amino acids were aspartic acid,glutamic acid,serine,glycine,histidine,arginine,threonine,alanine,proline,tyrosine,valine,methionine,cystine,isoleucine,leucine,phenylalanine,and lysine;and the average contents were 3.41-7.23,4.64-9.66,2.05-3.75,2.99-4.95,0.01-1.56,2.33-4.85,2.10-4.03,2.67-5.48,5.37-7.64,1.45-3.49,2.70-5.53,0.01-0.48,3.64-4.78,1.91-4.15,3.96-7.83,2.39-4.60,1.85-3.65 mg·g-1,respectively.There were significant differences in the contents of seventeen kinds of amino acids,total amino acids,total essential amino acids,total essential amino acids for children,medicinal amino acids,and bitter amino acids in Eriobotryae folium at different harvesting stages(P＜0.05).The content of bitter amino acids in total amino acids was stable,and there was no significant difference.The content of essential amino acids was from 44.26%to 50.33%in Eriobotryae folium at different harvesting periods,significantly higher than the WHO/FAO model value(35.00%).The mean values of EAA/NEAA(55.67%)and EAA/TFAA(35.74%)were close to 60%and 40%of the WHO/FAO model values,respectively.The highest content of seventeen kinds of amino acids in Eriobotryae folium was found in July and followed in November.SRC values ranged from 62.53 to 76.17;the highest value was November,the second was August,and the third was July.Lysine was the first limiting amino acid in Eriobotryae folium.Bitter amino acids were positively correlated with medicinal and total amino acids(P＜0.01).Conclusions The amino acids in Eriobotryae folium have a complete variety,reasonable composition,and good development and utilization value.The contents of amino acids in different months varied greatly.July and November were the optimal periods for the rational development and utilization of amino acids in Eriobotryae folium.

Background::Heterotaxy (HTX) is a thoracoabdominal organ anomaly syndrome and commonly accompanied by congenital heart disease (CHD). The aim of this study was to analyze rare copy number variations (CNVs) in a HTX/CHD cohort and to examine the potential mechanisms contributing to HTX/CHD.Methods::Chromosome microarray analysis was used to identify rare CNVs in a cohort of 120 unrelated HTX/CHD patients, and available samples from parents were used to confirm the inheritance pattern. Potential candidate genes in CNVs region were prioritized via the DECIPHER database, and PNPLA4 was identified as the leading candidate gene. To validate, we generated PNPLA4-overexpressing human induced pluripotent stem cell lines as well as pnpla4-overexpressing zebrafish model, followed by a series of transcriptomic, biochemical and cellular analyses. Results::Seventeen rare CNVs were identified in 15 of the 120 HTX/CHD patients (12.5%). Xp22.31 duplication was one of the inherited CNVs identified in this HTX/CHD cohort, and PNPLA4 in the Xp22.31 was a candidate gene associated with HTX/CHD. PNPLA4 is expressed in the lateral plate mesoderm, which is known to be critical for left/right embryonic patterning as well as cardiomyocyte differentiation, and in the neural crest cell lineage. Through a series of in vivo and in vitro analyses at the molecular and cellular levels, we revealed that the biological function of PNPLA4 is importantly involved in the primary cilia formation and function via its regulation of energy metabolism and mitochondria-mediated ATP production. Conclusions::Our findings demonstrated a significant association between CNVs and HTX/CHD. Our data strongly suggested that an increased genetic dose of PNPLA4 due to Xp22.31 duplication is a disease-causing risk factor for HTX/CHD.

OBJECTIVE To comprehensively evaluate the quality of Eriobotrya japonica leaves from different producing areas. METHODS The contents of alcohol-soluble extracts were determined by hot-dipping method using 30 batches of E. japonica leaves from different producing areas as samples. The contents of total flavonoids and total triterpene acids were determined by ultraviolet spectrophotometry. The contents of five kinds of triterpenic acids （euscaphic acid，crataegolic acid，corosolic acid，oleanolic acid and ursolic acid） were determined by HPLC. The quality of E. japonica leaves from different producing areas was comprehensively evaluated by using entropy weight technique for order preference by similarity to an ideal solution （TOPSIS）. The bivariate correlation analysis of E. japonica leaves was conducted by SPSS 22.0 software in terms of weight， comprehensive evaluation value， the content of alcohol-soluble extract， the contents of total flavonoids， total triterpene acids and five triterpenic acids. RESULTS The contents of alcohol-soluble extract in 30 batches of E. japonica leaves were （24.56±0.08）%-（34.85±0.13）%； the contents of total flavonoids were （4.69±0.11）-（14.23±0.27） mg/g； the contents of total triterpene acid were （27.58±0.59）- （63.95±1.27） mg/g； the contents of euscaphic acid， crataegolic acid， corosolic acid， oleanolic acid and ursolic acid were （0.728± 0.011）-（6.064±0.063）， （0.526±0.013）-（3.245±0.022）， （1.222±0.025）-（8.807±0.094）， （0.856±0.021）-（2.931±0.075）， （4.704±0.087）-（11.806±0.283） mg/g， respectively. The analysis result of entropy weight TOPSIS method showed that the top three samples with comprehensive evaluation values （No.Kjcx-5） were S14 （Huotian Town， Yunxiao County， Zhangzhou，Fujian）， S19 （Qinnan District， Qinzhou， Guangxi） and S29 （Guoyang County， Bozhou， Anhui）. Comprehensive evaluation 0596-2559522。E-mail：jxrcwxp@163.com of E. japonica leaves was positively correlated with the contents of five kinds of triterpenic acids， such as euscaphic acid， crataegolic acid， corosolic acid， oleanolic acid and ursolic acid （P＜0.01）. The weight of E. japonica leaves was positively correlated with the comprehensive evaluation value （P＜0.01）. CONCLUSIONS The qualities of E. japonica leaves from different producing areas are very different. Among them， the qualities of E. japonica leaves from Huotian Town， Yunxiao County， Zhangzhou of Fujian， Qinzhou Qinnan District of Guangxi， and Bozhou Guoyang County of Anhui are relatively better. The weight of E. japonica leaves is positively correlated with their quality.

OBJECTIVE To evalu ate the quality of crude drug and di fferent processed products of Eriobotryae Folium . METHODS Ten batches of Eriobotryae Folium were processed into honey-stir-baked Eriobotryae Folium ，ginger-juice-stir-baked Eriobotryae Folium ，ginger-juice-boiled Eriobotryae Folium ，licorice-juice-stir-baked Eriobotryae Folium ，licorice-juice-boiled Eriobotryae Folium ，stir-fried Eriobotryae Folium ，totally 70 batches of samples . The contents of alcohol-soluble extracts ，the contents of total triterpene acids （calculated by ursolic acid ）and five triterpene acids such as euscaphic acid were determined by hot-dipping method ，ultraviolet and visibe spectrophotometry and high performance liquid chromatography （HPLC），respectively. The fingerprints were established with HPLC and their similarity evaluation was conducted with Similarity Evaluation System of TCM Chromatographic Fingerprint （2004A）. Common peaks were identified by comparison with mixed control. Hierarchical clustering analysis ，principal component analysis and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed by using SPSS 22.0 software and SIMCA-P 14.1 software. RESULTS In Eriobotryae Folium ，honey-stir-baked Eriobotryae Folium ，ginger-juice-stir-baked Eriobotryae Folium ，ginger-juice-boiled Eriobotryae Folium ，licorice-juice-stir-baked Eriobotryae Folium ，licorice-juice-boiled Eriobotryae Folium ，stir-fried Eriobotryae Folium ，average contents of alcohol-soluble extracts were 25.90％，39.95％，27.44％，28.20％，28.38％，26.36％ and 29.26％；average contents of total triterpene acids were 40.62，49.33，52.56，46.38，52.17，55.06 and 53.41 mg/g；average contents of euscaphic acid ，crataegolic acid ，corosolic acid ， oleanolic acid ，ursolic acid and average total content were 1.966-4.808，1.459-2.824，4.525-8.172，1.294-1.817，6.294-8.470， 15.538-25.671 mg/g，respectively. There were 11 common peaks in 70 batches of samples ，and the peak 2，5，6，10 and 11 were identified as euscaphic acid ，crataegolic acid ，corosolic acid ， oleanolic acid and ursolic acid. The similarities of crude drug different processed products with crude drug fringer print were 0.919-1.000. Among 70 batches of samples ，10 batches of Eriobotryae Folium could be clustered into one category ，and 10 batches of ginger- juice-boiled Eriobotryae Folium could be clustered into one category ；other 50 batches of processed products of Eriobotryae Folium could be clustered into one category ； the cumulative variance contribution rate of the first two principal components was 80.682％；variable importance in projection （VIP）value was in descending order ，i.e. peak 2（euscaphic acid ）＞peak 5（crataegolic acid ）＞peak 6（corosolic acid ）＞peak 9 （unknown component ） ＞peak 11 （ursolic acid ）＞peak 10 （oleanolic acid ）， which of them were all higher than 1. CONCLUSIONS After processing ，the contents of alcohol-soluble extracts ，total triterpene acids and the total content of five triterpene acids （euscaphic acid ，crataegolic acid ，corosolic acid ，oleanolic acid and ursolic acid ）increased in varying degrees ， among which the content of alcohol-soluble extracts in honey-stir-baked Eriobotryae Folium was the highest ，the content of total triterpene acids in licorice-juice-boiled Eriobotryae Folium was the highest ，and total content of five triterpene acids in ginger- juice-boiled Eriobotryae Folium was the highest. Euscaphic acid ，crataegolic acid ，corosolic acid ，ursolic acid ，oleanolic acid and other components may be the differential components affecting the quality of raw and processed the leaves from Eriobotryae Folium .

Objective:To investigate the clinical application of orbital fat fascia flap in upper eyelid depression correction.Methods:From January 2015 to December 2020, 38 female patients (aged 25-55 years, average 37.5 years) with mild to moderate upper eyelid depression were treated with orbital fat fascia flap at plastic surgery department of Friendship Plastic Surgery Hospital affiliated to Nanjing Medical University. During the operation, the lateral part of the central orbital septal fat was transferred to the upper eyelid depression, and then the upper eyelid depression was corrected.Results:35 cases of upper eyelid depression were significantly improved postoperatively, 2 cases of double eyelid line became shallow after operation, and adjustment was performed again; 1 case had partial depression on one side and received autologous granular fat supplement transplantation. Postoperative effect was satisfied.Conclusions:The method of longitudinal separation and preservation of the capsule below the orbital septal for orbital septal fat transposition can better correct the upper eyelid depression while reducing fat absorption.

Objective:To explore the clinical application of the principle of priority of mechanics in open blepharoplasty.Methods:A retrospective analysis was performed on 96 patients with bilateral single eyelid. For patients with condylar epidermis, the modified Park method for epidermal epidermal correction was performed; for patients with mild ptosis, levator aponeurosis or levator aponeurosis was performed. Methods such as loosening adhesions, reducing tissues, reducing load, and increasing the strength of the meibomian plate through surgery can weaken the mechanical factors that affect the formation of double eyelid folds. Therefore, with less or even the use of suture force, the patient achieves a more ideal shape of the double eyelid folds when the eyes are opened.Results:The morphology of upper eyelids and skin sagging in all 96 patients were significantly improved. Among them, 2 cases had poor curvature of the double eyelid after operation, 1 had narrow double eyelid due to insufficient peeling, and 2 had bilateral asymmetry. The upper and lower eyelids of the other patients had natural morphology with open and closed eyes, scars of incisions were not obvious, and the results were satisfactory.Conclusions:During mild blepharoptosis correction combined with double eyelid surgery, The use of the principle of priority of mechanics to open the double blepharoplasty can reduce the incidence of complications such as shallowing and disappearing of double eyelid folds to a certain extent, and it is worth popularizing.

Objective To investigate biomechanical properties of double eyelid surgery and its clinical application in upper blepharoplasty .Methods In the mild ptosis correction combined with double eyelid surgery ,the main force from levator was assigned to upper tarsus to open eyes .At the same time ,not only it could ensure the enough height of palpebral fissure ,but also had relatively sta-ble and persistent double eyelid .For those who had sunken upper eyelid ,were given fat transposition and/or autologous fat grafting .For those who had medial epicanthal fold ,to achieve a pleasing eye ap-pearance ,we performed epicanthoplasty .Results After 6 months to 2 years of follow-up ,15 cases had unsatisfactory results and underwent secondary surgery .The revision reason was as follows :7 pa-tients had asymmetry double eyelid width ,3 patients had insufficient correction for ptosis ,2 patients had shallower and narrower double eyelid line .In 3 cases ,the correction of the upper sunken was in-sufficient .The remaining 164 patients with mild ptosis were well corrected ,and the double eyelid was stable and natural ,and the results were satisfactory .There were no major complications .Conclusions During mild blepharoptosis correction combined with double eyelid surgery ,reasonable treatment of the biomechanical balance has certain clinical significance for avoiding postoperative complications and improving the effect of double eyelid surgery .

Gastric cancer is a malignant tumor characterized by high morbidity and mortality. With the development of molecular biol-ogy technology and the emergence of various new omics detection techniques in recent years, molecular epidemiologists of gastric cancer have conducted extensive studies on the genetic and host factors, as well as gene-environment interactions associated with ex-posure to environmental factors in gastric cancer. In addition, epidemiologists have studied the evolution of precancerous gastric le-sions, the development of gastric cancer, and explored relevant biomarkers to provide major evidence for the prevention and control of gastric cancer. This review summarizes the latest advances in the molecular epidemiology of gastric cancer, including existing evi-dence in studies for candidate-approach-based serum/plasma biomarkers, genome-wide association, whole-exome sequencing, tissue microarrays, as well as studies on metabolomics and microbiomes. We expect to provide insights into the future of molecular epidemi-ology studies in gastric cancer, promoting etiologic research, and the precise prevention and control of gastric cancer.

Objective To analyze the effect of the rhinoplasty on body image in the patients receiving cosmetic surgery,to investigate the change of postoperative body image disturbance(BDD)and to analyze the influencing factors of preoperative BDD in order to provide a basis for the psychological health management and reference for the diagnosis and treatment of plastic surgery.Methods A prospective study was performed on 84 patients with rhinoplasty admitted to the Affiliated Friendship Aesthetic Plastic Surgery Hospital of Nanjing Medical University from January 2015 to March 2016.The general data were investigated.The Plastic Psychological State Self-rating Scale was adopted to evaluate the patient′s body image situation,which was reexamined at postoperative 1-3 months.Results The preoperative non-BDD accounted for 60.71％,the occurrence rate of BDD was 19.05％,the other mental disorders,mental diseases or nervous system disease which had no relation with the BDD accounted for 20.24％;the occurrence rate of postoperative BDD was significantly lower than that of preoperative BDD(P＜0.05),moreover the patients with non-BDD had no postoperative BDD occurrence.The scores of question 1-10 before operation in the BDD group were higher than those in the non-BDD group,the scores of question 1-4 after operation in the non-BDD group were decreased,the scores of question 1-4,6-10 in the BDD group were decreased,while the scores of question 1,7,9-10 in the BDD group were higher than those in the non-BDD group(P＜0.05).The proportion of preoperative rhinoplasty and plastic surgery in the BDD group was higher than that in the non-BDD group,the difference was statistically significant(P＜0.05).Conclusion The occurrence rate of BDD in the patients with rhinoplasty is higher,operation is conducive to lessen the BDD,moreover operation itself will not result in new BDD.