AIM To establish an UPLC-MS/MS method for simultaneous content determination of protocatechuic acid,epicatechin,chlorogenic acid,quercitrin,gaultherin and gaultheroside A in Gaultheria leucocarpa var.yunnanensis.METHODS The analysis was performed on a 40℃thermostatic Waters BEH C18 column(100 mm×2.1 mm,1.7 μm),with the mobile phase comprising of water(containing 0.1%formic acid)-acetonitrile(containing 0.1%formic acid)flowing at 0.3 mL/min in a gradient elution manner,and electron spray inoization source was adopted in positive and negative ion scanning with multiple reaction monitoring(MRM)mode.Hierarchical cluster analysis(HCA)and principal component analysis(PCA)was used to screen important components that affect the quality of medicinal materials.RESULTS Six constituents showed good linear relationships within their own ranges(R2≥0.998 2),whose average recoveries were 98.76%-101.88%with the RSDs of 1.0%-2.5%.The constituents of G.leucocarpa in the roots and aerial parts were quite different.Gaultherin,epicatechin and protocatechuic acid may be the quality mark constituents of G.leucocarpa.CONCLUSION This accurate and efficient method can be used for the quality control of G.leucocarpa.

Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P＜0.05).After continuation treatment,the remission rate was 54.59％(202 cases/370 cases),and the recurrence rate was 6.49％(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35％(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.

Objective To investigate the effectiveness of astragalosideⅣ(AS-Ⅳ)in ameliorating radiation-induced cardiomyocyte edema and its molecular mechanism.Methods The AC 16 cells were divided into blank group,model group,AS-Ⅳ pre-irradiation administration group(Q group),post-irradiation administration group(H group)and pre-post-irradiation administration group(Q+H group).H group was incubated with 40 mol·L-1 AS-Ⅳ drug-containing medium,and the other groups were incubated with normal medium for 24 h.After 24 h of incubation,6 Gy X-ray irradiation was given to establish the cardiomyocyte edema model in all groups except the blank group,and group Q was replaced with normal medium,and group H was replaced with 40 mol·L-1 AS-Ⅳ drug-containing medium for 24 h of incubation.Calcein AM staining was used to observe the edema of AC 16 cells,Western blot method was used to detect the expression of key proteins of aqueous fluid metabolism,and Annexin-V/PI flow apoptosis assay was used to detect apoptosis of AC 16 cells.Results The area of cellular edema in blank,model,Q,H,and Q+H groups were 690.77±199.55,1 184.47±307.36,713.65±152.48,809.72±262.85 and 897.61±213.66;the relative expression levels of hypoxia inducible factor(HIF)-1α protein were 0.94±0.02,1.35±0.03,0.91±0.03,0.69±0.02 and 0.86±0.03;the relative expression levels of aquaporin 4(AQP4)protein were 0.66±0.03,1.07±0.04,0.67±0.02,0.56±0.03 and 0.56±0.02;the apoptosis rates were(3.90±0.76)％,(16.58±0.63)％,(12.91±0.51)％,(14.05±0.22)％and(12.13±0.38)％,respectively.Statistically significant differences were found between the above indicators in the blank,Q,H and Q+H groups when compared to the model group(all P＜0.05).Conclusion AS-Ⅳ can regulate water-liquid metabolism,ameliorate radiation-induced cardiomyocyte edema,and attenuate apoptosis by inhibiting the abnormal activation of the HIF-1 α/AQP4 axis in irradiated AC 16 cells.

Objective To establish the pharmacokinetic model of linezolid in neonates,and to optimize the administration regimen. Methods A prospective study was conducted among 64 neonates with sepsis who received linezolid as anti-infective therapy,and liquid chromatography-tandem mass spectrometry was used to measure the plasma concentration of the drug. Clinical data were collected,and nonlinear mixed effects modeling was used to establish a population pharmacokinetic (PPK) model. Monte Carlo simulation and evaluation was performed for the optimal administration regimen of children with different features. Results The pharmacokinetic properties of linezolid in neonates could be described by a single-compartment model with primary elimination,and the population typical values for apparent volume of distribution and clearance rate were 0.79 L and 0.34 L/h,respectively. The results of goodness of fit,visualization verification,and the Bootstrap method showed that the model was robust with reliable results of parameter estimation and prediction. Monte Carlo simulation results showed that the optimal administration regimen for linezolid in neonates was as follows:6 mg/kg,q8h,at 28 weeks of gestational age (GA);8 mg/kg,q8h,at 32 weeks of GA;9 mg/kg,q8h,at 34-37 weeks of GA;11 mg/kg,q8h,at 40 weeks of GA. Conclusions The PPK model established in this study can provide a reference for individual administration of linezolid in neonates. GA and body weight at the time of administration are significant influencing factors for the clearance rate of linezolid in neonates.

Objective:To investigate the clinical characteristics and perinatal outcomes of preeclampsia (PE) with severe fetal growth restriction (FGR) as the initial symptom.Methods:This retrospective cohort study included cases of singleton live births with PE and severe FGR delivered at Fujian Maternity and Child Health Hospital from January 2012 to December 2022. The cases were divided into two groups based on the sequence of severe FGR and hypertension onset: the severe FGR-first group and the hypertension-first group. General data, clinical characteristics, pregnancy complications, and neonatal outcomes were analyzed between the two groups. Statistical analyses were performed using t-tests, Mann-Whitney U tests, and Chi-square tests. Multivariate linear regression or logistic regression analyses were used to adjust for the effects of confounding factors on perinatal outcomes. Results:(1) A total of 307 cases were included in the study, with 194 cases (63.2%) in the severe FGR-first group and 113 cases (36.8%) in the hypertension-first group. Compared to the hypertension-first group, the severe FGR-first group had a higher proportion of severe FGR before 32 weeks, later gestational age at PE diagnosis, lower proportion of early-onset PE, greater gestational age at pregnancy termination, and shorter interval from PE diagnosis to pregnancy termination [40.7% (46/113) vs. 59.3% (115/194), χ2=9.87; (32.8±5.1) weeks vs. (35.6±3.4) weeks, t=5.12; 52.2% (59/113) vs. 25.8% (50/194), χ2=21.80; (34.7±3.1) weeks vs. (36.0±3.2) weeks, t=3.43; all P<0.01]. There was no statistically significant difference in the interval between the diagnosis of severe FGR and hypertension between the two groups. (2) Compared to the hypertension-first group, the severe FGR-first group had a lower preterm birth rate and a higher incidence of premature rupture of membranes [69.0% (78/113) vs. 46.9% (91/194), χ2=14.12; 9.7% (11/113) vs. 19.1% (37/194), χ2=4.72; both P<0.05]. After adjusting for differences in gestational age at termination of pregnancy using multivariate logistic regression analysis, the results showed no statistically significant differences in the incidence of pregnancy complications between the two groups. (3) Compared with the hypertension-first group, the severe FGR-first group had higher neonatal birth weight [(1 757±605) g vs. (2 067±684) g, t=4.12], longer birth length [(41.7±4.3) cm vs. (43.4±4.6) cm, t=3.10], and heavier placentas [(399±158) g v s. (486±147) g, t=2.36]. The rates of cesarean section, severe small for gestational age, and low birth weight were lower [85.8% (97/113) vs. 68.6% (133/194), χ2=11.35; 65.5% (74/113) vs. 49.5% (96/194), χ2=7.40; 87.6% (99/113) vs. 69.6% (135/194), χ2=12.80; all P<0.05]. There were no statistically significant differences in the 1-minute Apgar scores and NICU admission rates between the two groups. After adjusting for differences in gestational age at termination of pregnancy using multivariate regression analysis, it was found that compared with the hypertension-first group, the severe FGR-first group had heavier neonates and a lower risk of cesarean section [ OR (95% CI) were 80.18 (0.95-159.42) and 0.51 (0.26-0.99), both P<0.05]. Conclusions:Pregnant women with severe FGR preceding PE have a later onset of PE and relatively better perinatal outcomes compared to those with hypertension preceding PE. It is necessary to strengthen the monitoring of blood pressure fluctuations in pregnant women with severe FGR preceding PE and fetal growth in pregnant women with hypertension preceding PE.

Cervical spondylosis is one of the main causes of abnormal blood pressure changes,and can cause coronary heart disease,arrhythmia and other cardio-and cerebrovascular diseases.The present articlepreliminarily reviews the pathogenesis,clinical features,diagnosis and treatment of hypertension caused by cervical spondylosis.

Objective:To study the risk factors of patients with hepatocellular carcinoma (HCC) to transcatheter arterial chemoembolization(TACE) refractoriness.Methods:The clinical data of 106 HCC patients who underwent TACE at the Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2021 were retrospectively studied. There were 90 males and 16 females, with the age of (59.9±9.3) years. These patients were divided into the TACE-refractory group ( n=47) and the control group ( n=59) based on whether TACE refratoriness occurred after surgery. Serum alpha-fetoprotein (AFP), protein induced by vitamin K absence or antagonist-II (PIVIKA-II), maximum diameter of tumor, number of tumor and tumor vascularization patterns between the two groups were compared. Multivariate logistic regression analysis was performed to analyse the risk factors of TACE refractoriness in patients with HCC after TACE. Results:The proportion of patients with AFP >400 μg/L, PIVIKA-II >40 AU/L, number of tumor and tumor vascularization patterns Ⅲ+ Ⅳ (uneven enhancement) were significantly higher in the TACE-refractory group than the control group (all P<0.05). The maximum diameter of tumor for patients in the TACE-refractory group was significantly larger than that in the control group ( Z=-2.41, P=0.016). Multivariate logistic regression analysis showed that patients with serum AFP >400 μg/L( OR=2.707, 95% CI: 1.008-7.271), multiple tumors ( OR=6.069, 95% CI: 2.115-17.415) and tumor vascularization patterns Ⅲ+ Ⅳ (uneven enhancement)( OR=7.813, 95% CI: 2.246-27.176) before the first TACE were at increased risks of TACE refractoriness (all P<0.05). Conclusion:Preoperative AFP >400 μg/L, multiple tumors and tumor vascularization patterns Ⅲ+ Ⅳ were independent risk factors for TACE refractoriness in patients with HCC.

Objective:The evidence-based and Delphi methods were used to construct the exercise program for hospitalized patients with diabetes foot to provide guidance for clinical practice.Methods:Evidence on exercise management of diabetic foot patients was systematically searched from BMJ Best Practice, UpToDate, Registered Nurses′ Association of Ontario and other domestic and foreign databases and professional association websites. The retrieval period was from the establishment of the database to April 2021. The quality of the included literature was independently evaluated, and the evidence of the literature meeting the quality standards was extracted and summarized to form the first draft of exercise program for inpatients with diabetic foot. After two rounds of Delphi expert letter consultation, the program items were revised, and the final draft of the exercise program for inpatients with diabetic foot suitable for clinical practice was formed.Results:The effective recovery rate of the two rounds of expert correspondence questionnaire both were15/15. The expert authority coefficient was 0.865 and 0.895 respectively. And the Kendall coordination coefficient was 0.232 and 0.291 (both P<0.01). An exercise program for inpatients with diabetic foot had been formed, including 5 modules(exercise evaluation, exercise prescription, exercise monitoring, post-exercise evaluation and exercise management), 12 items and 40 operational items. Conclusions:The exercise program for inpatients with diabetic foot constructed in this study is scientific and clinically applicable, which provide scientific guidance for clinical medical staff to carry out exercise practice.

Abstract: Objective To analyze the epidemiological characteristics, prevention and control strategies, measures and the effects achieved of malaria in Huangshi City from 1951 to 2021, and to offer a reference for further strengthening malaria eradication and control successes. Methods　Descriptive epidemiological methods were used to assess the prevalence, measurements, and impacts of malaria in different time periods based on data for malaria control in Huangshi City from 1951 to 2021, and we created "semi-log" line graphs and charts to display the prevalence of disease and the effort done in prior years in terms of prevention and control. Results　Between 1951 and 2021, 527 780 cases of malaria were recorded in Huangshi, with an average annual incidence rate of 40.07/10 000. The prevention and control of malaria has gone through four stages, namely, the high prevalence of malaria stage (1951-1979), the basic elimination stage (1980-1999), the consolidation stage (2000-2010), and the eradication stage (2011-2021). Different strategies and measures have been adopted in different epidemic periods. During the high epidemic period, great efforts have been made to carry out general surveys and treatments, and strengthen the management of symptomatic patients; during the eradication stage, prominent and classified prevention and control strategies were adopted. When the incidence rate dropped to below 1/10 000, the main measures adopted were malaria monitoring, including timely discovery and standardization of infectious sources, disposal of epidemic points, management of migrant population malaria and vector monitoring. Through active prevention and control, remarkable results were achieved, and the incidence rate of malaria fell to below 1/10 000 in 1989, reaching the level of "basic elimination of malaria" issued by the Ministry in 1999, and passed the provincial malaria elimination acceptance in 2015. In recent years, with the increasing labor exports and foreign exchanges, imported malaria has been on the rise. African countries are the main sources of imported malaria, and the main species is P.falciparum. Conclusions　Malaria was once one of the main infectious diseases endangering the health of people in Huangshi City. The preventive and control methods and procedures adopted in different epidemic periods are effective. Currently, we have entered the consolidation phase of malaria elimination, with the focus of work being to monitor, report, and timely and effectively respond to imported malaria cases, thus reducing the risk of local transmission.

Objective: To analyze the prevalence and the risk factors of fungal sepsis in 25 neonatal intensive care units (NICU) among preterm infants in China, and to provide a basis for preventive strategies of fungal sepsis. Methods: This was a second-analysis of the data from the "reduction of infection in neonatal intensive care units using the evidence-based practice for improving quality" study. The current status of fungal sepsis of the 24 731 preterm infants with the gestational age of <34⁺⁰ weeks, who were admitted to 25 participating NICU within 7 days of birth between May 2015 and April 2018 were retrospectively analyzed. These preterm infants were divided into the fungal sepsis group and the without fungal sepsis group according to whether they developed fungal sepsis to analyze the incidences and the microbiology of fungal sepsis. Chi-square test was used to compare the incidences of fungal sepsis in preterm infants with different gestational ages and birth weights and in different NICU. Multivariate Logistic regression analysis was used to study the outcomes of preterm infants with fungal sepsis, which were further compared with those of preterm infants without fungal sepsis. The 144 preterm infants in the fungal sepsis group were matched with 288 preterm infants in the non-fungal sepsis group by propensity score-matched method. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of fungal sepsis. Results: In all, 166 (0.7%) of the 24 731 preterm infants developed fungal sepsis, with the gestational age of (29.7±2.0) weeks and the birth weight of (1 300±293) g. The incidence of fungal sepsis increased with decreasing gestational age and birth weight (both P<0.001). The preterm infants with gestational age of <32 weeks accounted for 87.3% (145/166). The incidence of fungal sepsis was 1.0% (117/11 438) in very preterm infants and 2.0% (28/1 401) in extremely preterm infants, and was 1.3% (103/8 060) in very low birth weight infants and 1.7% (21/1 211) in extremely low birth weight infants, respectively. There was no fungal sepsis in 3 NICU, and the incidences in the other 22 NICU ranged from 0.7% (10/1 397) to 2.9% (21/724), with significant statistical difference (P<0.001). The pathogens were mainly Candida (150/166, 90.4%), including 59 cases of Candida albicans and 91 cases of non-Candida albicans, of which Candida parapsilosis was the most common (41 cases). Fungal sepsis was independently associated with increased risk of moderate to severe bronchopulmonary dysplasia (BPD) (adjusted OR 1.52, 95%CI 1.04-2.22, P=0.030) and severe retinopathy of prematurity (ROP) (adjusted OR 2.55, 95%CI 1.12-5.80, P=0.025). Previous broad spectrum antibiotics exposure (adjusted OR=2.50, 95%CI 1.50-4.17, P<0.001), prolonged use of central line (adjusted OR=1.05, 95%CI 1.03-1.08, P<0.001) and previous total parenteral nutrition (TPN) duration (adjusted OR=1.04, 95%CI 1.02-1.06, P<0.001) were all independently associated with increasing risk of fungal sepsis. Conclusions: Candida albicans and Candida parapsilosis are the main pathogens of fungal sepsis among preterm infants in Chinese NICU. Preterm infants with fungal sepsis are at increased risk of moderate to severe BPD and severe ROP. Previous broad spectrum antibiotics exposure, prolonged use of central line and prolonged duration of TPN will increase the risk of fungal sepsis. Ongoing initiatives are needed to reduce fungal sepsis based on these risk factors.
Infant ; Infant, Newborn ; Humans ; Birth Weight ; Intensive Care Units, Neonatal ; Retrospective Studies ; Tertiary Care Centers ; Infant, Extremely Low Birth Weight ; Gestational Age ; Infant, Extremely Premature ; Sepsis/epidemiology* ; Retinopathy of Prematurity/epidemiology* ; Bronchopulmonary Dysplasia/epidemiology*