ObjectiveTo reveal the changing pattern of fungal communities and isoflavone content during the fermentation of Sojae Semen Praeparatum. MethodsInternal transcribed spacer （ITS） amplicon sequencing was used to analyze the changes in fungal communities during the fermentation. High-performance liquid chromatography （HPLC） was employed to determine the composition and content of isoflavones. Spearman correlation analysis was conducted to identify fungal communities positively correlated with isoflavone content. ResultsDuring the fermentation of Sojae Semen Praeparatum， the abundance of Penicillium continued to increase and became the dominant genus from the "yellow cladding" to the early "secondary fermentation" stage （9 days）. However， in the mid-to-late "secondary fermentation" stage （12-21 days）， the abundance of Penicillium decreased， while the abundance of Barnettozyma increased rapidly， becoming the dominant genus during the later stages （18-21 days）. Alpha diversity analyses showed that fungal diversity was higher in the "secondary fermentation" stage than in the "yellow cladding" stage. Beta diversity analyses showed greater variability in fungal communities during the "yellow cladding" stage， with relatively stable fungal communities during the "secondary fermentation" stage. The aglycone isoflavone content exhibited a gradual increase， rising from 5.56% at the start of fermentation to 96.84% by the end. In contrast， the glucoside isoflavone content experienced a corresponding decline， decreasing from 94.44% to 3.16%. Spearman analysis showed that Penicillium， Barnettozyma， and Ilyonectria were positively correlated with the contents of daidzein， glycitein， and genistein， and promoted the conversion of isoflavones from glucoside to aglycone forms. ConclusionThe fungal communities of Penicillium， Barnettozyma， and Ilyonectria promote the conversion of isoflavones from glucoside to aglycone forms during the fermentation of Sojae Semen Praeparatum. The findings provide an important reference for improving the scalability and quality of Sojae Semen Praeparatu fermentation.

By reviewing the ancient and modern literature， the name， origin， scientific name evolution， place of origin， quality， harvesting， processing， efficacy and toxicity of Asteris Radix et Rhizoma（ARR） were systematically sorted out， so as to provide reference for the development and utilization of the relevant famous classical formulas. According to textual research， ARR was first contained in Shennong Bencaojing， all generations are Ziwan for its proper name， and there are still aliases such as Ziyuan， Ziqian and Xiaobianer. Its mainstream origin in successive generations was Aster tataricus， and there are also Ligularia fischeri and others in local area of use. The medicinal parts of ARR are root and rhizome， but in modern times， the rhizome is mostly used for propagation and cultivation， so some of ARR medicinal materials only have the root without the rhizome. The earliest recorded ancient origin of ARR was now Fangxian（Hubei）， Zhengding and Handan（Heibei）， then the range of production areas gradually expanded， the mainstream production areas from the Song dynasty to the Ming and Qing dynasties included Hebei， Jiangsu， Anhui， Henan and other places， since modern times， two major producing areas have been formed in Anguo， Hebei province and Bozhou， Anhui province. From the quality evaluation， it is clear that from ancient times， flexible roots and purple color are the best. The ancient harvesting was mainly in lunar February or March， and then dried in the shade， and the modern harvesting is mostly in spring and autumn， and the roots are braided into pigtails and then dried in the sun or dried in the sun after 1-2 d. The ancient and modern processing method of ARR are basically the same， mainly honey processing， there are still methods of frying， steaming， vinegar sizzling， etc. Based on the results， it is recommended that the dried roots and rhizomes of A. tataricus should be used in clinical and the development of related famous classical formulas， and those whose original formulas specify the processing requirements can be processed according to the relevant requirements， while whose processing requirements are not specified should be used in the form of raw products.

OBJECTIVE To explore the potential mechanism of the effect of Xuebijing injection （XBJ） on neurological function and survival of rats after cardiac arrest （CA）/cardiopulmonary resuscitation （CPR） based on the S-nitrosoglutathione reductase （GSNOR）/S-nitrosoglutathione （GSNO） pathway. METHODS The CA/CPR rat model was established by ventricular fibrillation. Using a sham operation group as control， high-throughput sequencing was employed to analyze and mine the differentially expressed genes （DEGs）. Enzyme-linked immunosorbent assay was used to determine the contents of GSNOR and GSNO in the hippocampus； the active components of XBJ were screened and subjected to molecular docking analysis with GSNOR. The rats successfully modeled using the same method were divided into model group （n＝30）， inhibitor （GSNOR inhibitor） group （n＝30）， XBJ group （n＝30） and XBJ+inhibitor group （n＝30）， and a sham operation group （n＝30） was set up. Neurological function was evaluated and survival status was recorded at 3 hours， 24 hours and 3 days after the first 89） drug intervention. The contents of GSNOR and GSNO in the hippocampus of rats were determined in each group at the 0191） above time points， and the relationship of the contents of GSNOR and GSNO with modified neurologic severity scale （mNSS） score was analyzed. RESULTS GSNOR coding gene was differentially expressed between the model group and the sham operation group. Compared with the sham operation group， GSNOR content increased significantly in the hippocampus of rats in model group， while GSNO content decreased significantly （P＜0.05）. The active components of XBJ， such as 4- methylenemiltirone and salviolone， could be bound to GSNOR protein， with the binding energy lower than －6 kcal/mol， mainly connected by hydrogen bonds. Animal experiments revealed that mNSS score and GSNOR levels in the hippocampus of rats in the model group were significantly higher than those in the sham operation group （P＜0.05）， while GSNO levels and survival rate were significantly lower than those in the sham operation group （P＜0.05）. The above indexes of rats were improved significantly in administration groups， the mNSS score in the XBJ group was significantly lower than that in the inhibitor group， the content changes of GSNOR and GSNO in the inhibitor group were more obvious than those in the XBJ group， and the various indicators in the XBJ+inhibitor group were significantly better than the XBJ group and the inhibitor group （P＜0.05）. GSNOR content was positively correlated with the mNSS score， and GSNO content was negatively correlated with the mNSS score （P＜0.05）. CONCLUSIONS XBJ can improve the neurological function of rats and enhance their survival rates after CA/CPR， the mechanism of which may be associated with the down-regulation of GSNOR and the up-regulation of GSNO.

Objective To investigate the levels of serum CXC-chemokine ligand 16(CXCL16)and anti-neu-trophil cytoplasmic antibody(ANCA)in patients with allergic rhinitis and their clinical diagnostic value.Meth-ods A total of 84 patients with allergic rhinitis(allergic rhinitis group)treated in the hospital from January to December 2022 were selected as the study objects,and were divided into mild group(44 cases)and moderate and severe group(40 cases)according to the severity of their disease.Another 80 healthy subjects who had physical examination in the same period were selected as the control group.The levels of CXCL16 and ANCA in serum were determined by enzyme-linked immunosorbent assay.The correlation between serum CXCL16 and ANCA levels and inflammatory factors[interleukin(IL)-4,IL-9,IL-13]and immunoglobulin E(IgE)was analyzed by Pearson.The value of serum CXCL16 and ANCA levels in the diagnosis of moderate and severe allergic rhinitis was evaluated by receiver operating characteristic(ROC)curve.Results Compared with con-trol group,the levels of IL-4,IL-9,IL-13 and IgE in allergic rhinitis group were significantly increased,and the difference was statistically significant(P＜0.05).Compared with control group,serum CXCL16 and ANCA levels in allergic rhinitis group were significantly increased,and the differences were statistically significant(P＜0.05).The area under the curve(AUC)of serum CXCL16 and ANCA in patients with allergic rhinitis was 0.897 and 0.844,respectively.The AUC of combined diagnosis was 0.959,both of which were better than that of individual diagnosis(Z=2.164,3.474,P＜0.05),and the specificity was 93.75％.The sensitivity was 89.29％.The levels of serum CXCL16 and ANCA in patients with allergic rhinitis increased with the se-verity of the disease(P＜0.05).Pearson correlation analysis showed that serum CXCL16 and ANCA levels were positively correlated with IL-4,IL-9,IL-13 and IgE in patients with allergic rhinitis(P＜0.05).ROC curve analysis results showed that the AUC of the patients diagnosed with moderate and severe allergic rhini-tis by serum CXCL16 and ANCA was 0.862 and 0.832,respectively,and the AUC of the combined diagnosis of CXCL16 and ANCA was 0.949,both of which were better than those diagnosed separately(Z=1.981,2.378,P＜0.05),and the specificity was 90.91％.The sensitivity was 90.00％.Conclusion The levels of se-rum CXCL16 and ANCA in patients with allergic rhinitis increased significantly,and increased with the severi-ty of the patients'disease,both of which have certain value in the clinical diagnosis of allergic rhinitis.

Objective:To investigate the impact of intraoperative multimodal neurophysiological monitoring combined with blood pressure precise control on incidence of acute cerebral infarction after carotid endarterectomy.Methods:A retrospective study was peformed; 305 patients with atherosclerotic stenosis of the carotid artery admitted to and accepted carotid endarterectomy in Department of Vascular Neurosurgery, Dong'e County People's Hospital from January 2020 to September 2023 were selected. Intraoperative multimodal neurophysiological monitoring combined with traditional empirical modalities for blood pressure control was applied to 153 patients admitted to our hospital from January 2020 to December 2021 (control group), and intraoperative multimodal neurophysiological monitoring combined with blood pressure precise control (based on monitored sensory or motor wave amplitude changes) was applied to 152 patients admitted to our hospital from January 2022 to September 2023 (experimental group). Difference in postoperative acute cerebral infarction incidence between the 2 groups was compared.Results:The experimental group had significantly lower postoperative acute cerebral infarction incidence compared with the control group (4.6% vs. 13.0%, P<0.05). The experimental group had significantly lower postoperative asymptomatic acute cerebral infarction incidence compared with the control group (3.3% vs. 9.8%, P<0.05), while no significant difference was noted in postoperative symptomatic acute cerebral infarction incidence between the 2 groups ( P>0.05). Conclusion:Intraoperative multimodal neurophysiological monitoring combined with blood pressure precise control can reduce the postoperative acute cerebral infarction incidence in patients accepted carotid endarterectomy, especacailly postoperative asymptomatic acute cerebral infarction incidence, thereby enhancing surgical safety.

By consulting ancient and modern literature， the herbal textual research of Farfarae Flos has been conducted to verify the name， origin， producing area， quality evaluation， harvesting and processing methods， so as to provide reference for the development and utilization of the famous classical formulas containing Farfarae Flos. According to the research， the results showed that Farfarae Flos was first described as a medicinal material by the name of Kuandonghua in Shennong Bencaojing（《神农本草经》）， and the name was used and justified by later generations. The main origin was the folwer buds of Tussilago farfara， in addition， the flower buds of Petasites japonicus were used as medicine in ancient times. The ancient harvesting time of Farfarae Flos was mostly in the twelfth month of the lunar calendar， and the modern harvesting time is in December or before the ground freeze when the flower buds have not been excavated. Hebei， Gansu， Shaanxi are the authentic producing areas with the good quality products. Since modern times， its quality is summarized as big， fat， purple-red color， no pedicel is better. Processing method from soaking with licorice water in the Northern and Southern dynasties to stir-frying with honey water followed by micro-fire in the Ming dynasty， and gradually evolved to the modern mainstream processing method of honey processing. Based on the research results， it is suggested that the dried flower buds of T. farfara， a Compositae plant， should be selected for the development of famous classical formulas containing Farfarae Flos， and the corresponding processed products should be selected according to the specific processing requirements of the formulas， and raw products are recommended for medicinal use without indicating processing requirements.

[Objective] To summarize the diagnosis and treatment of Antopol Goldman lesion (AGL) in clinical practice. [Methods] Clinical data and diagnosis and treatment process of one AGL case treated in our hospital were retrospectively analyzed, and relevant literature was reviewed. [Results] The patient presented with painless gross hematuria and right-sided lower back pain.Imaging examination suggested swelling of the right kidney, blood accumulation in the right calyx, renal pelvis and lower ureter, blood clot in the bladder, and multiple small stones in the left kidney.After multidisciplinary consultation, close imaging follow-up, interventional and flexible ureterdscope examination, tumors of hematological diseases, renal hematuria, arteriovenous fistula and collection system were excluded.After conservative treatment, the patient gradually recovered.During the follow-up of 1 year, no hematuria or low back pain recurred. [Conclusion] There is no clear diagnostic standard for AGL.Diagnosis relies on imaging, interventional methods and ureteroscopy.It is necessary to exclude other diseases and adopt conservative treatment.

Objective This study aims to investigate the current status of burnout among anesthesi-ology residents,and to explore its influencing factors and potential interventions.Methods A total of 2 651 practicing anesthesiology residents from 218 hospitals nationwide were included in this study.Demographic characteristics,occupational features,and psychological resilience scores(Connor-Davidson resilience scale)were collected using a questionnaire distributed electronically.The Maslach burnout inventory-human service survey(MBI-HSS)was used to assess burnout.A comparison between groups with and without occu-pational burnout was conducted.Multiple logistic regression analysis was used to identify risk factors for burnout among anesthesiology residents.Results Out of the expected 2 651 questionnaires,1 990 valid responses were received(response rate 77.7%).The prevalence of burnout among the residents was 53.4%(1 063/1 990).Compared with residents without occupational burnout,those with burnout had a signifi-cantly higher proportion of females,working in tertiary hospitals,unmarried individuals,frequency of en-countering challenging patients,participating in on-call duty,and research tasks,and had a significantly lon-ger weekly working hours(P＜0.05).Multivariate logistic regression analysis indicated that female(OR = 1.58,95%CI 1.28-1.97,P＜0.01),longer working hours(OR = 1.62,95%CI 1.45-1.81,P＜0.01),and higher frequency of encountering challenging patients(OR = 1.11,95%CI 1.11-1.40,P＜0.01)were risk factors for occupational burnout.High levels of psychological resilience was protective factor against burnout(OR = 0.86,95%CI 0.84-0.88,P＜0.01).Conclusion The occurrence of burnout among anesthesiology residents is high.It is crucial to focus on and design practical preventive measures to en-hance psychological resilience,ensuring healthy physical and mental development of the resident community.

OBJECTIVE To evaluate the effects of different fresh processing methods on the quality of Puerarial Lobatae Radix using entropy weight TOPSIS model and multi-index. METHODS By optimizing the specifications of fresh cut(thick slices of 2, 3, 4 mm thick, the side length of 0.5, 1, 1.5 cm), drying method(drying at 45, 65, 85 ℃, freeze drying) and other parameters, Puerarial Lobatae Radix medicinal materials were processed at the origin, and Puerarial Lobatae Radix decoction pieces were obtained. Using the content of 3′-hydroxy puerarin, puerarin, puerarin apioside, 3′-methoxy puerarin, puerarin-6″-O-xyliside, daidzin, genistin, daidzein, ethanol soluble extractives, as well as moisture and ash content limits as evaluation indicators, through the entropy and TOPSIS method to analyze the index component data and optimizing the Puerarial Lobatae Radix best when fresh herbs processing technology. RESULTS Different fresh processing methods had a certain influence on the content of the index components of Puerarial Lobatae Radix, and the best cutting specification was 0.5 cm thick, and the best drying method was freezed drying. CONCLUSION The entropy weight TOPSIS method can be used to evaluate the effects of different processing methods on the quality of Puerarial Lobatae Radix, and the best processing technology obtained has good stability and repeatability, which can provide guidance for the standardization of processing technology of Puerarial Lobatae Radix.

OBJECTIVE To optimize the processing technology of wine steamed Cnidii Fructus. METHODS The content of xanthotoxol, xanthotoxin, bergapten, isobergapten, imperatorin and osthole was used as the evaluation index. The response surface methodology combined with entropy weight method was used to investigate the adding amount of rice wine, the soaking time and the steaming time with aim to find the best processing technology. RESULTS The best processing technology for Cnidii Fructus with wine steaming was: adding 30 g of rice wine 4 mL for infiltrating 18.5 h, and steaming for 10 h. CONCLUSION The optimized wine steaming process is stable and feasible. The establishment of an HPLC analytical method for the determination of 6 components in wine steamed Cnidii Fructus is accurate and reliable, which can be used for the quality control of wine steamed Cnidii Fructus decoction pieces.