BACKGROUND:The diabetic microenvironment can cause excessive M1 polarization of macrophages,and this hyperglycemic inflammatory state can inhibit osteogenic differentiation of bone marrow mesenchymal stem cells,thus affecting the healing of diabetic bone defects.Studies have indicated that mogroside V possesses anti-inflammatory,antioxidant,and hypoglycemic properties.However,its potential to modulate M1 polarization of macrophages and osteogenic differentiation of bone marrow mesenchymal stem cells under high glucose and inflammatory condition remains unclear. OBJECTIVE:To explore the effect of mogroside V on regulating M1 macrophage polarization and its effect on osteogenic differentiation of bone marrow mesenchymal stem cells under high glucose and inflammatory condition. METHODS:Murine diabetic models were established using C57BL/6 mice.Bone marrow-derived macrophages were isolated from tibia and fibula of normal and diabetic mice,and cultured in low-glucose and high-glucose media.Then M1 polarization of bone marrow-derived macrophages was induced using lipopolysaccharide and interferon-γ.Bone marrow-derived macrophages were treated with 160,320,and 640 μmol/L mogroside V.Flow cytometry was employed to determine the proportion of F4/80+CD86+cells.qRT-PCR was utilized to assess mRNA expression levels of inducible nitric oxide synthase,interleukin 1β,and interleukin 6.ELISA was employed to evaluate tumor necrosis factor-α secretion in bone marrow-derived macrophage supernatants.Bone marrow mesenchymal stem cells were isolated from tibia and fibula of C57BL/6 suckling mice,and induced osteogenic differentiation using low-or high-glucose osteogenic induction medium.Bone marrow mesenchymal stem cells were treated with M1 macrophage-conditioned mediums with or without 320 μmol/L mogroside V in osteogenic differentiation process.qRT-PCR was employed to assess the mRNA expression of alkaline phosphatase,Runt-related factor 2,osteocalcin,and osteopontin on day 14 after osteogenic induction.Alizarin red staining and quantitative analysis were conducted to evaluate calcium deposition on day 21 after osteogenic induction. RESULTS AND CONCLUSION:(1)Flow cytometry results showed that with the treatment of 320 and 640 μmol/L mogroside V,the proportion of F4/80+CD86+bone marrow-derived macrophages was significantly lower than that in the high-glucose control group(P<0.05).(2)qRT-PCR results showed that with the treatment of 160,320,and 640 μmol/L mogroside V,the mRNA expression levels of inducible nitric oxide synthase and interleukin 6 were significantly lower than that in the high-glucose control group(P<0.05).With the treatment of 320 and 640 μmol/L mogroside V,the mRNA expression level of interleukin 1β was significantly lower than that in the high-glucose control group(P<0.05).(3)ELISA results exhibited that with the treatment of 160,320,and 640 μmol/L mogroside V,the tumor necrosis factor-α secretion level was significantly lower than that in the high-glucose control group(P<0.05).(4)With the treatment of 320 μmol/L mogroside V,calcium salt deposition was increased in bone marrow mesenchymal stem cells under high glucose and inflammatory conditions(P<0.05),and the mRNA relative expression levels of alkaline phosphatase,Runt-related factor 2,and osteopontin were increased(P<0.05).These findings indicate that mogroside V can promote osteogenic differentiation of bone marrow mesenchymal stem cells by inhibiting the M1 polarization of bone marrow-derived macrophages under high glucose and inflammatory conditions and reducing the generation of inflammatory factors.

To investigate the efficacy of amiodarone and lidocaine in cardiac arrest patients.

BACKGROUND:Sepsis is one of the main causes of mortality in intensive care units(ICUs).Early prediction is critical for reducing injury.As approximately 36%of sepsis occur within 24 h after emergency department(ED)admission in Medical Information Mart for Intensive Care(MIMIC-IV),a prediction system for the ED triage stage would be helpful.Previous methods such as the quick Sequential Organ Failure Assessment(qSOFA)are more suitable for screening than for prediction in the ED,and we aimed to find a light-weight,convenient prediction method through machine learning. METHODS:We accessed the MIMIC-IV for sepsis patient data in the EDs.Our dataset comprised demographic information,vital signs,and synthetic features.Extreme Gradient Boosting(XGBoost)was used to predict the risk of developing sepsis within 24 h after ED admission.Additionally,SHapley Additive exPlanations(SHAP)was employed to provide a comprehensive interpretation of the model's results.Ten percent of the patients were randomly selected as the testing set,while the remaining patients were used for training with 10-fold cross-validation. RESULTS:For 10-fold cross-validation on 14,957 samples,we reached an accuracy of 84.1%±0.3%and an area under the receiver operating characteristic(ROC)curve of 0.92±0.02.The model achieved similar performance on the testing set of 1,662 patients.SHAP values showed that the five most important features were acuity,arrival transportation,age,shock index,and respiratory rate. CONCLUSION:Machine learning models such as XGBoost may be used for sepsis prediction using only a small amount of data conveniently collected in the ED triage stage.This may help reduce workload in the ED and warn medical workers against the risk of sepsis in advance.

ObjectiveTo analyze the quality changes of Platycladi Semen before and after the deterioration of moth-eaten and rancidity during storage. MethodFour types samples of Platycladi Semen， including normal， moth-eaten， oxidative rancidity and hydrolytic rancidity， were determined for volatile components， odor， and taste based on headspace solid phase microextraction/gas chromatography-mass spectrometry （HS-SPME/GC-MS） and electronic sensory techniques such as electronic nose and electronic tongue. Volatile components were identified by searching the database and manual comparison， the odor and taste were determined by the response values of the electronic nose and electronic tongue sensors， and the difference between samples before and after deterioration was studied by multivariate statistical analysis. ResultA total of 85 compounds were identified in Platycladi Semen samples. Compared with the normal samples， the number of volatile compounds in samples after hydrolytic rancidity decreased by 5， the number of volatile compounds in samples after moth-eaten and oxidative rancidity increased by 1 and 21， respectively. Aldehydes and acids accounted for majority of types. Among them， the contents of N-hexanoic acid， hexanal and propionic acid in the samples of oxidative rancidity reached 11.49%， 10.21% and 7.52%， which became the key indicators of rancidity. There was significant variance among the odor components corresponding to W1W， W2W and W1S sensors by electronic nose analysis. It was indicated that the value of sourness in deteriorated samples generally increased by mean of electronic tongue analysis. Compared with normal samples， the moth-eaten samples had changed slightly and rancidity samples had changed significantly especially oxidative rancidity samples of volatile components， odor and taste by multivariate statistical analysis. ConclusionIn terms of Platycladi Semen， the oxidative rancidity caused by nature storage for 12 months has the greatest impact on the quality. Therefore， it should be mainly to prevent oxidative rancidity to ensure the quality of Platycladi Semen.

BACKGROUND: It is common for patients with lung cancer to have concomitant coronary artery disease, some of them have underwent coronary stenting and accepted antiplatelet therapy. Whether antiplatelet agents should be continued in the perioperative period remains controversial, especially in patients requiring lung cancer resection with coronary artery stents. We reviewed the data of our institute to clarify the perioperative outcomes of this specific population. METHODS: We retrospectively analyzed the data on patients who underwent pulmonary resection for lung cancer following coronary stent placement between January 2013 and September 2019 in the Department of Thoracic Surgery in Peking University First Hospital. All of them discontinued oral antiplatelet agents before operation at least 5 days. The primary outcomes were the cardiovascular morbidity and mortality in hospital. RESULTS: 111 patients were identified and included in the analysis. The time intervals between stenting and lung surgery were 1-3 months, 3-12 months, and more than 12 months in 6.3%, 13.5% and 80.2% of the patients, respectively. Sublobectomy, lobectomy, biolobectomy, pneumonectomy and sleeve lobectomy were performed in 10.8%, 71.2%, 9.0%, 2.7% and 6.3% of the patients. The overall incidences of cardiovascular complications were 11.6%, including unstable angina (n=1, 0.9%), hypotention (n=1, 0.9%), congestive heart failure (n=2, 1.8%) and new-onset atrial fibrillation (n=10, 9.0%). There was no perioperative death. No major adverse cardiac events (MACE) occurred. CONCLUSIONS It was safety to discontinued oral antiplatelet agents before operation, with no MACE and death in perioperative period.

Objective:To explore the applification value of self-manufacture anti-fall alarm system on elderly inpatients at high risk of falls.Methods:A total of 110 elderly inpatients at high risk of falls were randomly assigned to experiment group (55 cases) and control group (55 cases), the control group were given routine care of fall prevention, the experiment group was carried out self-manufactured anti-fall alarm system. Patients were followed up for 2 weeks, the fall rates in two groups were recorded, the fall efficacy was assessed by modified fall efficacy scale at enrollment and discharge, the nursing care satisfaction was eveluated by nursing needs and satisfaction scale.Results:There was no fall patient in the experiment group, and 4 fall patients (7.3%) in the control group, the fall rate was significantly decreased in the experiment group compared to the control group ( χ2 value was 4.151, P=0.042). The scores of take a bath or a shower, get in/out of bed, answer the door or telephone, walk around the inside of your house and total MFES scores were significantly increased in the experiment group compared to the control group [(4.55±0.81)points, (6.68±1.39)points, (5.23±1.14)points, (5.97±0.86)points, (67.98±4.28)points vs. (3.13±0.49)points, (5.27±0.94)points, (4.57±1.10)points, (4.57±0.55)points, (63.17±3.66)points], the differences was statically significant ( t value was 3.090-11.049,all P<0.05). The scores of service and technology, environment and guidance, overall evaluation were significantly increased in the experiment group compared to the control group [(51.60±13.75)points, (46.76±14.18)points, (5.97±0.72)points vs (45.67±9.17)points, (41.65±10.82)points, (5.29±0.90)points], the differences was statically significant ( t value was 2.124-4.424,all P<0.05). There were 91.7% (11/12) nurses satisfacted to the self-manufactured anti-fall alarm system. Conclusion:Self-manufactured anti-fall alarm system can effectively prevent fall incidence and promote fall efficacy and nursing care satisfaction of elderly inpatients at high risk of falls.

Objective To establish HPLC fingerprints for the identification of Ilicis Rotundae Cortex (Jiubiying), dried bark of Ilex rotunda Thunb., and its adulterant, dried bark of Ilex godajam (Colebr.) Wall.. Methods Some samples named Jiubiying were collected from some medicine markets and drugstores. The HPLC fingerprints were obtained to detect Jiubiying and Ilex godajam. The software Similarity Evaluation System of Chromatographic Fingerprints of Traditional Chinese Medicine (2004A edition) was used to evaluate fingerprints. Results The fingerprints of Jiubiying and Ilex godajam were established. Methodological study met the technical requirements of fingerprints. There were 31 and 28 common peaks in Jiubiying and Ilex godajam, respectively. Jiubiying and Ilex godajam could be classified into two clusters by principal component analysis and hierarchical clustering analysis. Conclusion Jiubiying and Ilex godajam can be identified by HPLC fingerprints. This method can provide an effective method for quality evaluation of Jiubiying.

Objective To evaluate the quality coherence of commercial Angelicae Dahuricae Radix (Baizhi) decoction pieces. Methods The samples of 12 batches of commercial decoction pieces, 1 batch of sulphur fumigated Baizhi, and 1 batch of naturally dried Baizhi were collected. HPLC method was used to determine the fingerprints and the contents of imperatorin and isoimperatorin by C18 column (4.6 mm×250 mm, 5 μm) with a gradient mobile phase of acetonitrile-water solution system at the flow rate of 1.0 mL/min. The column temperature was set at 35 ℃, and the max plot of detection wavelength was in 210-800 nm. Similarity calculation was used to analyze the data. Results The HPLC fingerprint analysis method was established with 12 common peaks. The similarities of 12 batches of commercial decoction pieces of Baizhi were 0.840-0.973. Their similarities compared with the sulphur fumigated Baizhi were 0.672-0.908. Compared with naturally dried Baizhi, the similarities of fingerprint were 0.536-0.684. The contents of imperatorin and isoimperatorin in 12 batches of commercial decoction pieces were 0.035%-0.140% and 0.028%-0.069%, respectively. Conclusion The quality of Baizhi decoction pieces was consistent. It can be speculated that Baizhi decoction pieces were processed with sulphur fumigation.

Objective To study the correlation between storage time and the content of 5-hydroxymethylfurfural (5-HMF) in Corni Fructus because of the color change caused by storage time. Methods Corni Fructus samples of different storage time with 0, 1, 2, 3, and 4 years were collected. The contents of 5-HMF were determined by HPLC. Results The HPLC determination method of 5-HMF in Corni Fructus was established. The contents of 5-HMF varied from undetected value to 0.292 8%, with the increase of storage time of 0, 1, 2, 3, and 4 years and the color gradually deepened from red, dark red, reddish brown to brown. The contents of 5-HMF in black wine-prepared Corni Fructus were 0.954 4%-1.837%. Conclusion The browning of Corni Fructus is related to the production of 5-HMF. With the extension of storage time of Corni Fructus, the color gradually deepens and the content of 5-HMF increase significantly. The storage time of Corni Fructus can be suggested to be one year.

Objective To sdudy the expression of p53 and nm23-H1 proteins and their clinical significance in nasopharyngeal carcinoma.Methods The expression of p53 and nm23-H1 proteins were detected by immunohistochemistry method in 40 cases with nasopharyngeal carcinoma and 22 cases with chronic inflammation of nasopharyngeal mucosa tissues.Results Positive rates of p53 and nm23-H1 in chronic nasopharyngitis group were 1.0 ％,27.2 ％,and in the NPC group were 92.5 ％,55.0 ％.There were 9 cases with the positive expression of p53 in 22 cases of nasopharyngeal carcinoma tissues with the positive expression of nm23-H1 (40.9 ％).There were 17 cases with the positive expression of p53 in 18 cases with the negative expression of nm23-H1 (94.4 ％).The expression of p53 and nm23-H1 proteins in nasopharyngeal carcinoma were much higher than that in chronic inflammation of nasopharyngeal mucosa tissues.The expression of p53 protein in nasopharyngeal carcinoma with metastatic lymph node was higher than that in nasopharyngeal carcinoma without metastatic lymph node,but nm23-H1 protein lower.The expression of p53 protein was positively correlated with the metastasis,clinnical staging and pathological classification but not correlated with T classification of nasopharyngeal carcinoma.The expression of nm23-H1 protein was negative correlation with the metastasis and clinical staging of nasopharyngeal carcinoma.Conclusion p53 and nm23-H1 play important coordinated regulation roles in the carcinogenesis,development and metastasis of nasopharyngeal carcinoma and will probably become the key biological marks in the judging and evaluating prognosis of nasopharyngeal carcinoma.