ObjectiveThrough qualitatively and quantitatively analysis of the differences in chemical composition between the combined decoction and single decoction of Huaganjian and comparison of their core efficacy， to explore the rationality of the flexible clinical application of Huaganjian compound preparations and single-flavored dispensing granules. MethodsUltra performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS） was used to qualitatively analyze the combined decoction and single decoction samples of Huaganjian， and meanwhile， the contents of four index components（geniposide， paeoniflorin， hesperidin and paeonol） were quantitatively analyzed by high performance liquid chromatography（HPLC）. Nonalcoholic fatty liver disease（NAFLD） rat model induced by high-fat diet was applied to compare the efficacy of combined decoction and single decoction of Huaganjian. A total of 30 male SD rats were randomly divided into the control group， model group， lovastatin group（1.8 mg·kg^-1）， combined decoction group（1.26 g·kg^-1） and single decoction group（1.18 g·kg^-1）. After successful modeling， lovastatin group， combined decoction group and single decoction group were given corresponding doses of drugs by intragastric administration every day， and the control group and model group were given equal amounts of normal saline by intragastric administration， after 4 weeks of administration， the serum and liver tissues were collected， and the contents of alanine aminotransferase（ALT）， aspartate aminotransferase（AST）， total cholesterol（TC）， triglyceride（TG）， low-density lipoprotein cholesterol（LDL-C） and high-density lipoprotein cholesterol（HDL-C） in serum of rats were detected， and the liver pathological examination was carried out by hematoxylin-eosin（HE） staining and oil red O staining， so as to compare differences of their efficacy. ResultsSeventy chemical components were initially identified and attributed from the lyophilized powder of the combined decoction and single decoction samples of Huaganjian， and there was no obvious difference in composition between the two. Further quantitative analysis showed that the contents of geniposide， paeoniflorin， hesperidin and paeonol in the combined decoction samples were significantly increased when compared with those of the single decoction samples（P<0.01）. The pharmacodynamic results showed that compared with the model group， both the combined and single decoction groups of Huaganjian could improve the liver index of NAFLD rats， reduce the serum levels of AST， ALT， TC， TG and LDL-C， increase the serum level of HDL-C， and ameliorate the pathological changes of liver cell steatosis and fat accumulation. However， there was no significant difference in pharmacodynamic effects between the combined decoction group and the single decoction group. ConclusionThere is no significant difference between the combined decoction and single decoction of Huaganjian in terms of chemical composition， but the contents of the four index components show significantly difference. Both of them can significantly improve the fat accumulation and liver function in NAFLD rats. This study provides a reference basis for the rational clinical application and evaluation of famous classical formula compound preparations and single-flavored dispensing granules.

Sodium ; Wastewater ; Potassium ; Diet ; Blood Pressure ; China ; Sodium, Dietary ; Sodium Chloride, Dietary

Aim To anticipate the mechanism of zuka- mu granules (ZKMG) in the treatment of bronchial asthma, and to confirm the projected outcomes through in vivo tests via using network pharmacology and molecular docking technology. Methods The database was examined for ZKMG targets, active substances, and prospective targets for bronchial asthma. The protein protein interaction network diagram (PPI) and the medication component target network were created using ZKMG and the intersection targets of bronchial asthma. The Kyoto Encyclopedia of Genes and Genomics (KEGG) and gene ontology (GO) were used for enrichment analysis, and network pharmacology findings were used for molecular docking, ovalbumin (OVA) intraperitoneal injection was used to create a bronchial asthma model, and in vivo tests were used to confirm how ZKMG affected bronchial asthma. Results There were 176 key targets for ZKMG's treatment of bronchial asthma, most of which involved biological processes like signal transduction, negative regulation of apoptotic processes, and angiogenesis. ZKMG contained 194 potentially active components, including quercetin, kaempferol, luteolin, and other important components. Via signaling pathways such TNF, vascular endothelial growth factor A (VEGFA), cancer pathway, and MAPK, they had therapeutic effects on bronchial asthma. Conclusion Key components had strong binding activity with appropriate targets, according to molecular docking data. In vivo tests showed that ZKMG could reduce p-p38, p-ERKl/2, and p-I

The molecularly imprinted polymers membranes(MIPMs)were prepared for selective adsorption of lamotrigine(LTG)in plasma by surface molecular imprinting technology with polyvinylidenefluoride(PVDF)membranes as supporter,lamotrigine as template molecule,methyl methacrylate as functional monomer,ethylene glycol dimethacrylate as cross-linking agent,azodiisobutyronitrile as initiator and acetonitrile-dimethylformamide(1∶1.5,V/V)as pore-forming agent.The prepared MIPMs were characterized by scanning electron microscope,Fourier transform infrared spectroscopy,Brunaner-emmet-teller measurements,X-ray photoelectron spectroscopy,and thermogravimetric analysis.The adsorption properties of the materials were investigated by kinetic adsorption,isothermal adsorption,selective adsorption,adsorption-desorption and reusability experiments.The results showed that the imprinted layer of LTG was successfully coated on the surface of PVDF,and the materials had uniform particle size.The adsorption capacity and imprinting factor of the MIPMs towards LTG were 3.77 mg/g and 8.97,respectively.The nanomaterials showed fast mass transfer rate(30 min)and good reusability(the adsorption efficiency was 86.66%after 6 cycles),and could be used for the adsorption of LTG in plasma with low matrix interference,recoveries of 86.54%-90.48%and RSD of 1.51%-3.15%(n=5).The proposed LTG MIPMs were demonstrated to be simple and environment friendly,and had high selectivity in rapid separation and extraction of LTG in plasma.

BACKGROUND:There is controversy regarding the need for marrow reaming in intertrochanteric fractures of the femur.Some believe that unreaming shortens operative time,reduces bleeding,and decreases intraoperative risk in elderly patients,but there is no basis for whether this move reduces the effectiveness of intramedullary nail support.Others believe that reaming allows for the selection of thicker diameter intramedullary nails for better mechanical support,but basic studies have shown that this approach carries risks such as fat embolism and destruction of bone(especially in elderly patients with osteoporosis). OBJECTIVE:To analyze the mechanical distribution characteristics of reamed and unreamed proximal femoral nail antirotation-Ⅱ in the treatment of type 31-A3 intertrochanteric fractures by finite element analysis. METHODS:A healthy volunteer was included,and CT scans of his femur were obtained in DICOM format,and the files were sequentially imported into Mimics,Geomagic Wrap,SolidWorks,Hypermesh,and Ansys software for processing.The A3.1,A3.2,and A3.3 intertrochanteric fracture models were obtained and assembled with 9 mm,11 mm diameter,and 170 mm length intramedullary nails,respectively,followed by assigning material properties,setting the interaction relationship of each contact surface and defining the load and boundary conditions,and then solved.The femoral stress distribution,internal fixation stress distribution,femoral displacement,and internal fixation displacement were observed in different models. RESULTS AND CONCLUSION:(1)The femoral stress was less than that of unreamed intramedullary nail fixation for each type of fracture,and the maximum stress value of the femur for A3.3 fracture was greater than that of A3.1 and A3.2.(2)The internal fixation stress was greater than that of unreamed intramedullary nail fixation for each type of fracture,and the maximum stress value of internal fixation for A3.3 fracture was greater than that of A3.1.(3)Reamed versus unreamed intramedullary nailing has less effect on femoral and internal fixation displacement and more effect on stress.(4)It is indicated that the use of reamed intramedullary nail fixation results in a reduction in femoral stress,an increase in the stress borne by the internal fixation as a whole,and a reduction in the stress borne by the distal locking nail.The use of reamed intramedullary nail fixation may provide better treatment results compared to unreamed intramedullary nail fixation.

Objective To understand the changing trend of Internet outpatient visits in public hospitals,and provide support for the development planning of Internet hospitals.Methods Using the data of Internet outpatient visits in a public hos-pital from January 2021 to June 2023,the ARIMA model and GM(1,1)model were constructed respectively.The mean absolute error(MAE)and root mean square error(RMSE)were used to evaluate the fitting effect,and the Internet outpatient visits from July to December 2023 were predicted based on the dominance model.Results ARIMA(1,2,1)model and GM(1,1)model were used to predict the number of return visits of Internet outpatient service.The average absolute errors were 369.86 and 978.84,and the root-mean-square errors were 479.49 and 1444.83,respectively.The ARIMA(0,1,0)model and GM(1,1)model were used to predict the number of Internet outpatient consultations.The average absolute errors were 297.23 and 369.62,and the root-mean-square errors were 413.61 and 496.30,respectively,indicating that the ARIMA model has a good prediction effect.The forecast results show that the predicted value of Internet outpatient visits in December 2023 is 14,831 cases,and the predicted value of consultation visits is 7461 cases.Conclusion The number of Internet outpatient visits in a public hospital will continue to rise from 2021 to 2023.Therefore,hospitals should fully realize the importance of Internet medical services,take ac-tive measures to continuously optimize the medical service model,and provide patients with high-quality,efficient and convenient Internet medical services.

Objective To investigate the changing trend of the current situation of Internet-based oncology outpatient treatment and provide support for the development and management of Internet hospitals.Methods The ARIMA and GM(1,1)models were constructed based on the Internet-based outpatient data of a cancer hospital from January 2021 to June 2023,and the fitting effect was evaluated by mean absolute error(MAE)and root mean square error(RMSE).Based on the model,the pro-portion of Internet-based outpatient visits and the offline outpatient visits were predicted from July to December 2023.Results ARIMA(1,1,2)and GM(1,1)models were used to predict the proportion of Internet-based outpatient visits.The average abso-lute errors were 2.06%and 2.41%,and the root-mean-square errors were 3.01%and 3.17%,respectively.The ARIMA(0,1,1)and GM(1,1)models were used to predict the proportion of Internet-based outpatient visits to the offline outpatient visits,with the rate of the average absolute errors of 0.58%and 1.08%,respectively,and the rate of the root mean square errors 0.75%and 1.31%,respectively.The figures indicated that the ARIMA model had a better prediction effect.The forecast results showed that the predicted value of Internet outpatient service in December 2023 was 90.35%,and the predicted value of Internet-based outpatient service accounted for 16.46%of the offline outpatient service.Conclusion In 2021-2023,the proportion of Inter-net-based outpatient visits in the cancer hospital showed a steady trend,and the proportion of Internet outpatient visits in the off-line outpatient visits showed a rising trend.Therefore,hospitals need to establish a continuous monitoring mechanism,constantly adjust management strategies and measures to meet the needs of patients and continue to promote the high-quality development of Internet-based medical services.

Objective: To evaluate the incidence, treatment, and survival outcomes of Swyer syndrome with gonadal non-dysgerminoma malignant germ cell tumor (MGCT-NDG). Methods: A retrospective study was performed on Swyer syndrome patients with MGCT-NDG between January 2011 and December 2022 in Peking Union Medical College Hospital to investigate their characteristics and outcomes. Results: A total of 15 patients (4.9%, 15/307) with Swyer syndrome were identified in 307 MGCT-NDG patients. The average age at diagnosis of MGCT-NDG and Swyer syndrome were (16.8±6.7) and (16.7±6.6) years, respectively. Six cases were preoperatively diagnosed as Swyer syndrome, of which 4 cases received bilateral gonadectomy with or without hysterectomy, while the other 2 cases underwent removal of gonadal tumor and unilateral gonadectomy with hysterectomy, respectively. Of the 9 patients postoperatively diagnosed as Swyer syndrome, unilateral gonadectomy, removal of gonadal tumor, and unilateral gonadectomy with hysterectomy were performed in 6 patients, 2 patients, and 1 patient, respectively. Mixed malignant germ cell tumor (MGCT;10 cases), yolk sac tumor (4 cases), and immature teratoma (1 case) were the pathological subtypes, in the descending order. There were International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ in 6 cases, stage Ⅱ in 3 cases, stage Ⅲ in 5 cases, and stage Ⅳ in 1 case, respectively. Eleven patients received reoperation for residual gonadectomy after a average delay of (7.9±6.2) months, including 8 MGCT-NDG patients and 1 gonadoblastoma patient, no tumor involved was seen in the remaining gonads in the other 2 cases. Ten patients experienced at least one recurrence, with a median event free survival of 9 months (5, 30 months), of which 2 patients received surgery only at the time of initial treatment. All patients with recurrence received surgery and combined with postoperative chemotherapy. After a median follow-up of 25 months (15, 42 months), 10 patients were disease-free, 3 patients died of the tumor, 1 died of side effects of leukemia chemotherapy, and 1 survived with disease. Conclusion: The incidence rate of Swyer syndrome in patients with MGCT-NDG is about 4.9%; timely diagnosis and bilateral gonadectomy should be emphasized to reduce the risk of reoperation and second carcinogenesis in this population.
Female ; Humans ; Retrospective Studies ; Gonadal Dysgenesis, 46,XY/surgery* ; Gonadoblastoma/surgery* ; Neoplasms, Germ Cell and Embryonal/surgery* ; Ovarian Neoplasms/pathology*

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.

Quercetin can mediate the activation of mitogen-activated protein kinase(MAPK)signaling pathways to prevent osteoporosis(OP).This paper comprehensively discusses the interrelationship between MAPK and osteoporosis-related cells based on the latest domestic and international research.Additionally,it elucidates the research progress of quercetin in mediating the MAPK signaling pathway for OP prevention.The aim is to provide an effective foundation for the clinical prevention and treatment of OP and the in-depth development of quercetin.