New steroids from the pericarps of Datura metel L

Three new steroids (1-3) and 13 reported analogs (4-16) were extracted from Datura metel L. pericarps. Structure analysis of these extracted compounds was performed by 1 D-NMR and 2 D-NMR spectroscopy, and their spectra were compared with those of similar compounds previously described in the literature. The extracted steroids (1-3) and known compounds (4-16) were evaluated for anti-inflammatory activity against LPS-activated RAW 264.7 cells. Compounds 5, 7, 9, 12 and 15 showed potential anti-inflammatory activity with IC50 less than 35 μM, while compounds 3 and 11 showed weak anti-inflammatory activity with IC50 less than 100 μM.

Anti-Inflammatory and α-Glucosidase Inhibitory Triterpenoid with Diverse Carbon Skeletons from the Fruits of Rosa roxburghii

The fruits of Rosa roxburghii Tratt. are edible nutritional food with high medicinal value and have been traditionally used as Chinese folk medicine for a long time. In this study, 26 triterpenoids including four new pentacyclic triterpenoids, roxbuterpenes A-D (1, 4, 5, and 24), along with 22 known analogues (2, 3, 6-23, 25, and 26), were isolated from the fruits of R. roxburghii. Their chemical structures were determined on the basis of extensive spectroscopic analyses (including IR, HRESIMS and NMR spectroscopy). The absolute configuration of roxbuterpene A (1) was determined by an X-ray crystallographic analysis. This is the first report of the crystal structure of 5/6/6/6/6-fused system pentacyclic triterpenoid. Notably, roxbuterpenes A and B (1 and 4) possessed the A-ring contracted triterpenoid and nortriterpenoid skeletons with a rare 5/6/6/6/6-fused system, respectively. Compounds 1-7, 11, 13-15, 18-20, 24, and 25 exhibited moderate or potent inhibitory activities against α-glucosidase. Compounds 2, 4, 6, 11, and 14 showed strong activities against α-glucosidase with IC50 values of 8.4 ± 1.6, 7.3 ± 2.2, 13.6 ± 1.4, 0.9 ± 0.4, and 12.5 ± 2.4 μM, respectively (positive control acarbose, 10.1 ± 0.8 μM). Compounds 13, 14, and 16 moderately inhibited the release of NO (nitric oxide) with IC50 values ranging from 25.1 ± 2.0 to 51.4 ± 3.1 μM. Furthermore, the expressions of TNF-α (tumor necrosis factor-α) and IL-6 (interleukin-6) were detected by ELISA (enzyme-linked immunosorbent assay), and compounds 13, 14, and 16 exhibited moderate inhibitory effects on TNF-α and IL-6 release in a dose-dependent manner ranging from 12.5 to 50 μM.

[Strolling through the glorious years of Alveolar Surgery, bravely stepping onto the path of practice and innovation]

This article summarizes and organizes relevant publications in journals, along with a review of medical history, systematically summarizing the development process of dental alveolar surgery in China. The initial establishment phase (1935-1952) marked the starting point of Chinese Alveolar Surgery. Despite the impact of wars, it laid the foundation for subsequent research and practice. During the early development phase (1953-1966), the "Chinese Journal of Stomatology" was founded, which promoted the development of Alveolar Surgery. Research focused on tooth extraction methods and complications. Tooth Transplantation and Preprosthetic Surgery gradually began to take off. The stagnant phase (1967-1977) occurred due to the interruption of international exchanges, leading to an almost complete halt in the development of Alveolar Surgery. Entering the rapid catch-up phase (1978-1985), Alveolar Surgery scholars in China began striving to overcome the stagnation of the previous decade. While some progress was made, no significant innovative achievements emerged. In the scientific development phase (1986-2010), clinical research, basic experiments, and paper writing in modern Chinese Alveolar Surgery began to adhere to scientific standards with the rise of experimental medicine. The exploration and innovation stage (2011-2023) is the current development phase, during which Chinese Aveolar Surgery has reached its peak, making substantial progress in technology, clinical practices, and basic research, gradually reaching or even surpassing international advanced levels. Looking back at the development history in China, we can find the wisdom and hard work of the older generation of Alveolar Surgery scholars. However, contemporary challenges and issues, such as standardizing technology, promoting clinical practices, and talent cultivation, need to be addressed by present-day Alveolar Surgery professionals as they forge ahead.

Serum fibroblast growth factor-2 levels complement vital biomarkers for diagnosing heart failure

BACKGROUND

Early diagnosis of atrial fibrillation is important as it is crucial for improving patient outcomes. Fibroblast growth factor-2 (FGF2) may serve as a diagnostic biomarker for heart failure due to its ability to promote cardiac fibrosis and hypertrophy; however, the relationship between FGF2 concentration and heart failure is unclear. Therefore, this study aimed to explore whether FGF2 could aid in distinguishing patients with heart failure from healthy controls and those with dyspnea without heart failure. Additionally, to evaluate the possible correlation between serum FGF2 levels and its diagnostic parameters in patients with heart failure.

METHODS

Plasma FGF2 concentration was measured in 114 patients with a complaint of dyspnea (enrolled in the study between January 2022 and August 2022). Based on heart failure diagnosis, the patients were assigned to three groups, as follows: heart failure (n = 80), non-heart-failure dyspnea (n = 34), and healthy controls (n = 36), following physical examination. Possible correlations between serum FGF2 levels and other prognostic parameters in patients with heart failure were analyzed.

RESULTS

Serum FGF2 levels were higher in patients with heart failure (125.60 [88.95, 183.40] pg/mL) than in those with non-heart-failure dyspnea (65.30 [28.85, 78.95] pg/mL) and healthy controls (78.90 [60.80, 87.20] pg/mL) (p < 0.001). Receiver operating characteristic curve analysis identified FGF2 concentration as a significant predictor in heart failure diagnosis, with an area under the curve of 0.8693 (p < 0.0001). Importantly, in the heart failure group, serum FGF2 concentrations correlated with key prognostic parameters for heart failure, such as reduced left ventricular ejection fraction and elevated serum levels of N-terminal pro-B-type natriuretic peptide.

CONCLUSIONS

Elevated serum FGF2 level is strongly associated with an increased risk of heart failure and could serve as a useful biomarker to complement vital diagnostic parameters for heart failure.

Neutrophil-to-lymphocyte ratio at admission for early diagnosis, severity assessment, and prognosis of acute traumatic spinal cord injury

STUDY DESIGN

A retrospective study.

OBJECTIVE

This study examined the value of neutrophil-to-lymphocyte ratio at admission for early diagnosis, severity assessment, and prognosis of acute traumatic SCI.

SETTING

The First People's Hospital of Neijiang, China.

METHODS

This was a single-center, retrospective, cohort study of patients treated within 12 h of acute SCI between January 2018 and October 2022. Ninety-four SCI patients were selected as the Observation group, including 26 with complete injury (AIS grade A) and 68 with incomplete injury (AIS grade B-D), while 94 patients with simple spinal fracture were randomly selected as the Control group. Eighty-one observation group patients underwent surgical treatment, of which 33 had a higher AIS grade (Good prognosis subgroup) and 48 a lower or equal grade post-surgery (Poor prognosis subgroup). Univariate and multivariate analyses were performed to assess predictors of early diagnosis, severity, and 6-month outcome.

RESULTS

Initial white blood cell count, neutrophil count, monocyte count, and NLR were higher in the Observation group than the Control group, while lymphocyte count was lower in the Observation group. Multivariate logistic regression analysis identified NLR as an independent predictor of early diagnosis. Spinal canal encroachment ≥50%, neutrophil count, and NLR were higher in the complete injury subgroup, and spinal canal encroachment ≥50% was an independent predictor of complete injury, while NLR was not. The NLR was higher in the poor prognosis subgroup and was an independent risk factor.

CONCLUSIONS

Peripheral blood NLR is useful for early diagnosis of acute SCI and is predictive of clinical outcome.

Relocation of lower pole renal stones helps improve the stone-free rate during flexible ureteroscopy with a low complication rate

OBJECTIVE

To compare the efficacy and safety of relocating the lower pole stones to a favorable pole during flexible ureteroscopy with in situ lithotripsy for the treatment of 10-20 mm lower pole stone (LPS).

METHODS

This study was a prospective analysis of patient outcomes who underwent an FURS procedure for the treatment of 10-20 mm lower pole renal stones from January 2020 to November 2022. The patients were randomized into a relocation group or in situ group. The LPSs were relocated into a calyx, during lithotripsy in the relocation group was performed, whereas the in situ group underwent FURS without relocation. All the procedures were performed by the same surgeon. The patients' demographic data, stone characteristics, perioperative parameters and outcomes, stone-free rate (SFR), complications, and overall costs were assessed retrospectively.

RESULTS

A total of 90 patients were enrolled and analyzed in this study (45 per group) with no significant differences between the two groups in terms of age, gender, BMI, diabetes, hypertension, stone size, number, laterality, composition, and density. The mean operation time, total energy consumption, postoperative stay, and complications were similar between the groups. Both groups had similar SFR at 1 day postoperative follow-up (p = 0.091), while the relocation group achieved significantly higher SFR 3 months later (97.8% vs 84.4%, p = 0.026). The relocation group also had a significantly higher WisQol score than the in situ group (126.98 vs 110.18, p < 0.001).

CONCLUSION

A satisfactory SFR with a relatively low complication rate was achieved by the relocation technique during the FURS procedure.

Anti-inflammatory activity of a new lactone isolated from the leaves of Ardisia crenata Sims

One new lactone (1) named Ardisicreolide C, together with three saponin compounds, Ardisiacrispin B (2), Ardisicrenoside A (3), Ardisiacrispin A (4) were isolated and identified from the leaves of Ardisia crenata Sims. The structures of 1-4 were elucidated by 1D, 2D-NMR and HR-MS spectra and together with the published data. In view of structures with lactone moieties showed good anti-inflammatory activity, the anti-inflammatory effects of Ardisicreolide C on LPS-induced RAW264.7 cells were evaluated by enzyme linked immunosorbent assay (ELISA) method. As a result, Ardisicreolide C could reduce release of nitric oxide (NO), tumour necrosis factor α (TNF-α), interleukin 1β (IL-1β), interleukin 4 (IL-4) and interleukin 10 (IL-10) of the cell supernatant to exert anti-inflammatory activity. This indicates that the leaves as non-medicinal parts of Ardisia crenata Sims contain compounds with good anti-inflammatory activity, which provides a new direction for the discovery of anti-inflammatory drugs.

[Regulatory mechanisms and clinical significance of circadian disruption in intensive care unit patients]

Organisms adapt to the circadian changes in the external environment by regulating various life activity processes and establishing regular circadian cycles. A growing number of studies indicate that there is an extensive association between circadian disruption and critical illness, and circadian disruption is a pathological syndrome influencing the clinical outcome of critically ill patients. As a result of the disease itself, the ICU environment and medical interventions, critically ill patients often experience severe circadian disruption, which leads to aberrations in a wide range of physiological and behavioral functions of the organism, and finally exacerbates disease progression. In this paper, we reviewed the regulatory mechanisms of biological circadian rhythms, the causes and consequences of circadian disruption in critically ill patients, the assessment of circadian disruption, and strategies to restore circadian homeostasis to assist in the comprehensive treatment of critically ill patients.

[Preliminary insights into the practice of hypoallergenic home visiting program]

Allergic diseases affect about 40% of the world's population. Environmental factors are important in the occurrence and development of allergic diseases. Dust mites are one of the most important allergens in the indoor environment. The World Health Organization proposes the "four-in-one, combination of prevention and treatment" treatment principle for allergic diseases, in which environmental control to avoid or reduce allergens is the first choice for treatment. Modern people spend much more time at home (including sleeping) than outdoors, and the control of the home environment is particularly critical. This practice introduces the hypoallergenic home visit program, which including home environment assessment, environmental and behavioral intervention guidance, and common household hypoallergenic supplies and service guidance for the patient's home environment. The real-time semi-quantitative testing of dust mite allergens, qualitative assessments of other indoor allergens, record of patients' household items and lifestyle, and precise, individualized patient prevention and control education will be conducted. The hypoallergenic home visit program improves the doctors' diagnosis and treatment data dimension, and becomes a patient management tool for doctors outside the hospital. It also helps patients continue to scientifically avoid allergens and irritants in the environment, effectively build a hypoallergenic home environment, reduce exposure to allergens in the home environment, and achieve the goal of combining the prevention and treatment of allergic diseases.

New Monoterpenoid Indole Hybrids from Gelsemium elegans with Anti-Inflammatory and Osteoclast Inhibitory Activities

Gelsegansymines A (1) and B (2), two new indole alkaloids along with six known analogues (3-8) were isolated from the aerial parts of Gelsemium elegans. Their structures were elucidated by means of spectroscopic techniques. Structurally, compounds 1 and 2 possessed the rare cage-like gelsedine skeleton hybrid with bicyclic monoterpenoid. The anti-inflammatory activities of isolated compounds (1-3) were tested on LPS induced RAW264.7 cells. Under the treated concentration without toxicity for cells, the cytokines levels of nitric oxide (NO), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were evaluated by Griess method and enzyme-linked immunosorbent assay (ELISA). The results showed that compounds 1-3 exhibited anti-inflammatory activities with dose-dependent manner range from 12.5 to 50 μmol/L. Furthermore, the inhibitory activities of compounds 1 and 2 on receptor activator of NF-κB ligand (RANKL) induced osteoclast formation were tested in vitro. Compounds 1 and 2 at 5 μmol/L exhibited the significant inhibitory effect on the osteoclastogenesis induced by RANKL. This work reported the anti-inflammatory and osteoclast inhibitory activities of new monoterpenoid indole hybrids, which may inspire the further light on the related traditional application research of G. elegans.

[Characteristics of genioglossus neuromuscular activity in patients with obstructive sleep apnea during drug-induced sleep]

Objective: To analyze genioglossus (GG) activation responses to the negative pressure of upper airway cavity during awake and different sleep stages in patients with different obstructive sleep apnea (OSA) graduation. Methods: This prospective cohort study started from August 2019 to January 2021, recruited 42 male OSA patients aged from 21 to 59 (38.77±8.42) years. After completing whole night polysomnography (PSG) and upper airway CT, each subject underwent drug-induced sleep with simultaneous monitoring of genioglossal electromyography (GGEMG) and pressure of epiglottis (Pepi). Subjects were divided into three groups of mild OSA(7 males), moderate OSA(12 males), and severe OSA(23 males). The differences in upper airway CT measurements, parameters of GGEMG and Pepi during awake and induced sleep were compared. Statistical analysis was conducted by SPSS 21.0. Results: There was no significant difference in the GGEMG parameters between the mild and moderate groups. In wakefulness, the peak phasic GGEMG of the severe group was higher than the mild group (t=1.249, P=0.025), with no statistically difference in the corresponding Pepi. In the sleep onset, the GGEMG parameters and Pepi in severe group were higher than the other two groups. Linear regression analysis of the maximum GGEMG and maximum Pepi at the end of obstructive apnea (OA) in all moderate plus severe patients (n=35) was shown nonlinear correlation (r=0.28, P=0.694). The airway length of the glossopharyngeal cavity was linearly correlated with the maximum Pepi of OA (r=0.468, R2=0.219, P=0.005). Conclusions: The individual difference of GG activation in OSA patients is related to the severity of the disease (frequency of respiratory events) and negative pressure stimulation. In moderate and severe OSA patients, GG activity is not in harmony with the corresponding negative pressure stimulation, which may be one of the mechanisms leading to the aggravation of OSA.

Two new amides from the seeds of Coix lacryma-jobi var. lacryma-jobi

Phytochemical investigation of the seeds of Coix lacryma-jobi var. lacryma-jobi resulted in the isolation of eight compounds, including two new structures, coixdines A-B (1-2) and six known compounds (3-8). The structures of these compounds were determined by 1 D and 2 D NMR spectra referring to the literatures, together with HR-MS analysis. Coixdine A and B are first examples of spermidine skeleton in genus Coix. In the present paper, all compounds were evaluated for the cytotoxicity against two cancer cell lines (CT-26 and BxPC-3) in vitro, and none of the compounds exhibited obvious cytotoxic activity. The present investigation suggests that these amides seem to be of great chemotaxonomic value for C. lacryma-jobi.

Two new phenol compounds from roots of Ardisia crenata

Two new phenols, ardisiphenol I (1) and ardisiphenol J (2), along with three known compounds (3-5) were isolated and identified from the roots of Ardisia crenata var. bicolor. Their structures were elucidated by means of spectroscopic techniques. Structurally, new compounds 1 and 2 have rare side chain with seven carbons. All compounds were tested for antibacterial activity, and compound 5 showed moderate antibacterial activity against Enterococcus faecalis. This work provided the isolation and structural identification of all the compounds in detail, and shed a new light on its further research.

Undesirable ER stress induced by bavachin contributed to follicular atresia in zebrafish ovary

Fructus psoraleae (FP) is a commonly used herb with potential reproductive toxicity. Bavachin (BV), one of essential active ingredients of FP, was found to exhibit estrogenic activity, but its effect on female reproductive system remains unknown. In this study, the impact of BV on the female zebrafish reproductive system and underlying molecular mechanism were determined in vivo and ex vivo. The results showed that BV could accumulate in zebrafish ovary, leading to obvious follicular atresia and increase in gonadal index and vitellogenin content. Endoplasmic reticulum (ER) swelling and hypertrophy were observed in the BV-treated zebrafish ovary, accompanied by an increase in the expressions of ER stress and unfolded protein response (UPR) related genes, namely atf6, ire-1α and xbp1s. In the ex vivo study, BV was found to decrease the survival rate and maturation rate of oocytes, while increasing the expression of Ca2+. Additionally, BV led to an elevation in the level of estrogen receptor ESR1 and the expressions of genes involved in ER stress and UPR, including atf6, ire-1α, xbp1s, chop and perk. Moreover, molecular docking revealed that BV could directly bind to immunoglobulin heavy chain binding protein (BiP) and estrogen receptor 1 (ESR1). Besides, the alterations induced by BV could be partially reversed by fulvestrant (FULV) and 4-phenylbutyric acid (4-PBA), respectively. Thus, long-termed BV-containing medicine treatment could generate reproductive toxicity in female zebrafish by causing follicular atresia through BiP- and ESR-mediated ER stress and UPR, providing a potential target for the prevention of reproductive toxicity caused by BV.

[Diagnosis and treatment procedures and health management for patients with hereditary angioedema]

As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.

Sunlight irradiation promotes both the chemodiversity of terrestrial DOM and the biodiversity of bacterial community in a subalpine lake

Alpine lake habitats are evolving into subalpine lakes under the scenario of climate change, where the vegetation are promoted due to increasing temperature and precipitation. The abundant terrestrial dissolved organic matter (TDOM) leached from watershed soil into subalpine lakes would undergo strong photochemical reaction due to the high altitude, with the potential to alter DOM composition and affect the bacterial communities. To reveal the transformation of TDOM by both photochemical and microbial processes in a typical subalpine lake, Lake Tiancai (located 200 m below the tree line) was chosen. TDOM was extracted from the surrounding soil of Lake Tiancai and then subjected to the photo/micro-processing for 107 days. The transformation of TDOM was analyzed by Fourier-transform ion cyclotron resonance mass spectrometry (FT-ICR MS) and fluorescence spectroscopy, and the shift of bacterial communities was analyzed using 16s rRNA gene sequencing technology. Dissolved organic carbon and light-absorbing components (a₃₅₀) decay accounted for approximately 40% and 80% of the original, respectively, in the sunlight process, but both less than 20% in the microbial process for 107 days. The photochemical process promoted the chemodiversity as there were ∼7000 molecules after sunlight irradiation, compared to ∼3000 molecules in the original TDOM. Light promoted the production of highly unsaturated molecules and aliphatics, which were significantly associated with Bacteroidota, suggesting that light may influence bacterial communities by regulating the DOM molecules. Carboxylic-rich alicyclic molecules were generated in both photochemical and biological processes, suggesting TDOM was converted to a stable pool over time. Our finding on the transformation of terrestrial DOM and the alternation of bacterial community under the simultaneously photochemical and microbial processes will help to reveal the response of the carbon cycle and lake system structure to climate change for high-altitude lakes.

[A comparative study for the efficacies of transaxillary non-inflatable endoscopic surgery versus traditional surgery for papillary thyroid carcinoma]

Objective: To compare the efficacies between open surgery and axillary non-inflatable endoscopic surgery in papillary thyroid carcinoma (PTC). Methods: A retrospective analysis was performed on 343 patients with unilateral PTC treated by traditional open surgery (201 cases) and transaxillary non-inflating endoscopic surgery (142 cases) from May 2019 to December 2021 in the Head and Neck Surgery of Sichuan Cancer Hospital. Among them, 97 were males and 246 were females, aged 20-69 years. 1∶1 propensity score matching (PSM) was performed on the enrolled patients, and the basic characteristics, perioperative clinical outcomes, postoperative complications, postoperative quality of life (Thyroid Cancer-Specific Quality of Life), aesthetic satisfaction and other aspects of the two groups were compared after successful matching. SPSS 26.0 software was used for statistical analysis. Results: A total of 190 patients were enrolled after PSM, with 95 cases in open group and 95 cases in endoscopic group. Intraoperative blood losses for endoscopic and open groups were [20 (20) ml vs. 20 (10) ml, M (IQR), Z=-2.22], postoperative drainage volumes [170 (70)ml vs. 101 (55)ml, Z=-7.91], operative time [135 (35)min vs. 95 (35)min, Z=-7.34], hospitalization cost [(28 188.7±2 765.1)yuan vs. (25 643.5±2 610.7)yuan, x¯±s, t=0.73], postoperative hospitalization time [(3.1±0.9)days vs. (2.6±0.9)days, t=-3.24], and drainage tube placement time [(2.5±0.8) days vs. (2.0±1.0)days, t=-4.16], with statistically significant differrences (all P<0.05). There was no significant difference in surgical complications (P>0.05). There were significant diffferences between two groups in the postoperative quality of life scores in neuromuscular, psychological, scar and cold sensation (all P<0.05), while there were no statistically significant differences in other quality of life scores (all P>0.05). In terms of aesthetic satisfaction 6 months after surgery, the endoscopic group was better than the open group, with statistically significant difference (χ²=41.47, P<0.05). Conclusion: Endoscopic thyroidectomy by a gasless unilateral axillary approach is a safe and reliable surgical method, which has remarkable cosmetic effect and can improve the postoperative quality of life of patients compared with the traditional thyroidectomy.

Terpenoids with Cytotoxic Activity from Roots of Ardisia crispa

Three new terpenoids, ardisiacrispins G-I (1, 4 and 8), and eight known compounds, cyclamiretin A (2), psychotrianoside G (3), 3-hydroxy-β-damascone (5), megastigmane (6), corchoionol C (7), zingiberoside B (9), angelicoidenol (10), trans-linalool-3,6-oxide-β-D-glucopyranoside (11) were isolated from the roots of Ardisia crispa. The chemical structures of all isolated compounds were elucidated by extensive spectroscopic analyses, such as HR-ESI-MS, 1D and 2D NMR spectra. Ardisiacrispin G (1) represents the oleanolic-type scaffold featuring a rare 15,16- epoxy system. All compounds were evaluated for the cytotoxicity against two cancer cell lines (U87 MG and HepG2) in vitro. Compounds 1, 8 and 9 exhibited moderate cytotoxic activity with IC50 values ranging from 7.6±1.1 to 28.8±3.2 μM.

[Clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns]

Objective: To explore the clinical application effect of sequential nursing on the management of new skin on face and neck after deep burns. Methods: The retrospective case-control research approach was used. From January to December 2019, 109 patients who met the inclusion criteria were admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) within 1 week after deep burn wound healing on the face and neck. Fifty-five patients who were admitted to the hospital from January to June and received comprehensive treatment and conventional nursing were included in conventional nursing group (27 males and 28 females, aged 21-65 (40±17) years), and fifty-four patients who were admitted to the hospital from July to December and received comprehensive treatment and sequential nursing were included in sequential nursing group (29 males and 25 females, aged 18-57 (37±11) years). The scores of pigmentation, vascularity, pliability, and thickness in Vancouver scar scale (VSS), the total score of VSS, the score of itch's impact on sleep in the four-item itch questionnaire (FIIQ), and the total score of FIIQ of patients were counted in the two groups before the first treatment (hereinafter referred to as treatment) and 3 months, 6 months, and 1 year after treatment. The treatment effective rate and the score of patients' satisfaction with the treatment effect in one year after treatment and the occurrence of adverse reaction during the treatment were counted. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chi-square test. Results: The scores of pigmentation, vascularity, pliability, and thickness in VSS and the total VSS score of patients between the two groups before treatment were close (P>0.05). The pliability score in VSS and total VSS score after 3 months of treatment, the score of vascularity in VSS and total VSS score after 6 months of treatment, and the scores of pigmentation, vascularity, pliability, and thickness in VSS and total VSS score of patients after 1 year of treatment in sequential nursing group were significantly lower than those in conventional nursing group (with Z values of -2.51, -3.37, -2.05, -3.28, -3.12, -5.86, -4.63, -5.56, -6.76, respectively, P<0.05 or P<0.01). The score of itch's impact on sleep in FIIQ after 3 months of treatment of patients in sequential nursing group was significantly lower than that in conventional nursing group (Z=-4.17, P<0.01), and the total scores of FIIQ after 3 months, 6 months, and 1 year of treatment of patients in sequential nursing group were significantly lower than those in conventional nursing group (with Z values of -6.56, -5.53, -5.84, respectively, P<0.01). After 1 year of treatment, the treatment effective rate of patients in sequential nursing group was 96.3% (52/54), which was significantly higher than 81.8% (45/55) in conventional nursing group (χ2=5.83, P<0.05), and the score of patients' satisfaction with the treatment effect in sequential nursing group was significantly higher than that in conventional nursing group (Z=-4.49, P<0.01). During the treatment period, there was no adverse reaction in patients in sequential nursing group, but there were 3 patients with pruritus and peripheral erythema on the wound in conventional nursing group, which were improved after dressing changes. Conclusions: Sequential nursing can effectively improve the prevention and management of new skin scars in patients after deep burns on the face and neck, improve the itching, the efficiency of treatment, and the satisfaction of patients with the treatment effect.

[Clinical features and prognoses of re-operated patients for persistent/recurrent papillary thyroid carcinoma]

Objective: To investigate the clinicopathological characteristics and the survival of re-operated patients for persistent/recurrent papillary thyroid carcinoma (PTC) and risk factors for re-recurrence after the second operation. Method: A retrospective analysis of 69 cases underwent re-operation for persistent/recurrent PTC in Sichuan Cancer Hospital from January 2010 to December 2016 was performed. There were 21 males and 48 females, aged 14-85 (44.8) years old. According to the imaging after initial treatment, they were divided into a recurrence group (42 cases) and a persistent disease/residual group (27 cases). The positive rates of ipsilateral paratracheal lymph node metastases at re-operation were calculated and compared by chi-square test. Patients were divided into different subgroups according to potential risk factors for re-recurrence. Kaplan-Meier (K-M) method was used for survival analysis. Results: The positive rate of ipsilateral paratracheal lymph node metastasis in recurrence group (15/42, 35.7%) was significantly lower than that in the persistent disease/residual group (17/27, 63.0%) (χ²=4.91, P<0.05). The follow-up period after re-operation was 60-104 months, with a median of 66 months, and 8 patients were lost to follow-up. Permanent hypoparathyroidism occurred in 2 cases (2.9%) and permanent recurrent laryngeal nerve palsy in 1 case (1.4%). Twenty patients had structural recurrences and/or distant metastases. The 5-year disease-specific survival rate was 92.8% and the 5-year recurrence-free survival rate was 68.1%. Survival analysis was performed on risk factors such as age≥55 years old, recurrent tumor diameter ≥4 cm, number of positive lymph nodes ≥ 10, and obvious extracapsular invasion (ENE). Among them, age and diameter of recurrent tumor had significant influences on recurrence-free survival rate (χ² was 6.36, 8.17, respectively, both P values<0.05). There was a statistically significant difference in recurrence-free survival rates between ENE(+) group and ENE(-) group (χ²=5.52, P<0.05). Conclusion: For the re-operated patients due to persistence/ recurrence PTC, attention should be paid to protecting the parathyroid gland and recurrent laryngeal nerve during re-operation. Timely and effective postoperative follow-up for patients aged ≥ 55 years, with recurrent tumor diameter ≥ 4 cm and ENE(+), can significantly improve their prognoses.

A new ent-kaurane diterpenoid from the pericarps of Datura metel

A new ent-kaurane diterpenoid, named kaurane daturoside A (1), was isolated from the 70%-EtOH extract of dried pericarps of Datura metel L., along with six known terpenoids, 16α,17-dihydroxy-ent-kauran-19-diglycoside (2), cyclosieversioside F (3), astragaloside II (4), ginsenoside Rg1 (5), astrojanoside A (6), celerioside E (7). The isolated structures were elucidated by means of spectroscopic analyses, and the compounds 2, 3, 7 were separated from Solanaceae for the first time. Meanwhile, among isolates, compounds 2 and 5 exhibited anti-inflammatory activities against LPS-activated RAW264.7 cells (IC₅₀<11.00 μM).

[Emission of Nitrous Oxide (N2O) from Lake Taihu and the Corresponding Potential Driving Factors]

Nitrous oxide (N₂O) is one of the six greenhouse gases stipulated in the Kyoto Protocol. Its greenhouse potential over the past century was 298 times that of CO₂, and the concentration of atmospheric N₂O has been continuously and rapidly increasing during the past hundred years. Shallow lakes are an important source of atmospheric N₂O. In order to explore the temporal and spatial changes and potential driving factors of N₂O emissions from eutrophic water, we conducted field observations in February (winter) and August (summer) in Lake Taihu. We used the coefficient of diffusion-headspace bottle method to trace the variability in the N₂O concentration[c(N₂O)] and efflux[F(N₂O)] from surface water bodies and explored the potential driving factors of N₂O emissions. The optical measurements of dissolved organic matter (DOM) are an effective approach for tracing the source and composition of dissolved organic carbon (DOC) and dissolved organic nitrogen (DON). The migration and transformation processes of DOM also release a large amount of inorganic nitrogen, which changes the redox potential of the water column and thereby affects N₂O emissions. Our results showed that the variability in c(N₂O) and F(N₂O) in the surface waters of Lake Taihu were strongly affected by water temperature and nutrient levels. The average c(N₂O) of the surface waters was (19.7±2.7) nmol·L^-1, corresponding to a mean F(N₂O) of (41.1±1.8) μmol·(m²·d)^-1, and the means of both c(N₂O) and F(N₂O) were higher in summer than those in winter (t-test, P<0.01). The input and accumulation of DOM could increase the production and emission potential of N₂O in water bodies, as supported by both c(N₂O) and F(N₂O) significantly increasing with increasing level of terrestrial humic-like C1. The integration ratio of peak C to peak T I_C:I_T of DOM and the spectral slope S_275-295 results indicated that there were high inputs of terrestrial DOM in the northwestern inflowing river mouths, concurring with the high production and emission of N₂O found there. This suggested that the accumulation and degradation of terrestrial DOM potentially fueled the emission of N₂O. Our results showed that water temperature, DOM composition, and nutrient level were all important factors affecting N₂O emission from Lake Taihu. Long-term continuous observation can be applied to better evaluate the impact of various environmental factors on the production and emission of N₂O in water bodies and to help with providing scientific emission reduction plans.

[Emission of Methane from a Key Lake in the Eastern Route of the South-to-North Water Transfer Project and the Corresponding Driving Factors]

Lakes play an important role in the biogeochemical cycling of dissolved organic matter (DOM) and the emission of methane (CH₄). We investigated the concentration and effluxes of CH₄ and then analyzed the corresponding driving factors in Lake Luoma, a key lake along the South-to-North Water Transfer Project. Our results indicated that Lake Luoma was a hotspot of CH₄ emissions with an annual mean concentration and efflux of (0.12±0.09) μmol·L^-1 and (21.0±18.5) mmol·(m²·d)^-1, respectively. We found higher mean CH₄ levels in the wet season than those in the dry season and further higher levels than those in the wet-to-dry transition season. Spatially, the CH₄ efflux was higher in the northwest inflowing regions and lower in the southeast outflow regions. The variability in annual CH₄ efflux was affected by a combination of water temperature and hydrological conditions. Terrestrial input of dissolved organic carbon (DOC) and chromophoric DOM (CDOM) had fueled the production of CH₄ by providing necessary carbon substrates, and four PARAFAC DOM components were identified including a microbial humic-like C1, a tryptophan-like C2, a terrestrial humic-like C3, and a tyrosine-like C4. The CH₄ efflux from the lake was significantly promoted by the input and accumulation of terrestrial humic-like components, and Chl-a had no correlation with CH₄ efflux, suggesting that algal degradation was not directly fueling the emission of CH₄. Lake Luoma had been significantly disturbed by human activities, and terrestrial input of nutrient loading (TN and TP) into the lake not only improved the productivity and trophic level of the water body but also enhanced the production and release of CH₄ from the surface water. We concluded that the CH₄ emissions in Lake Luoma can be influenced by the combination of environmental factors, CDOM composition, and nutrient level. Long-term observation is needed for better evaluation of the driving factors in fueling the emission of CH₄ so as to effectively reduce the emissions of CH₄ and other greenhouse gases by taking corresponding countermeasures.

[Optical Composition and Potential Driving Factors of Chromophoric Dissolved Organic Matter in Large Lakes and Reservoirs in the Eastern Region of China]

Intensified urbanization has been occurring in the eastern region of China in recent decades, and excessive industrial and household sewage has been discharged into lakes and reservoirs, which has directly lowered water quality and destructed the functions of aquatic ecosystems. Lakes and reservoirs are typically drinking water sources supplying water for metropolitan areas as well as large- and medium-sized cities. Chromophoric dissolved organic matter (CDOM) is the colored fraction of DOM, and its source and optical composition strongly affect water supply safety and the health of surrounding citizens. In April 2021, we collected 68 samples from Reservoir Changtan (n=11), Lake Taihu (n=25), Lake Hongze (n=18), and Lake Gaoyou (n=14), and we further carried out 28 days of laboratory bio-incubation, together with optical measurements and parallel factor analysis (EEMs-PARAFAC) to analyze the bio-degradability ω(BDOC), sources, and optical composition of CDOM in these waters. The results showed that after 28 days of laboratory bio-incubation, the bioavailability of dissolved organic carbon (BDOC) of the four lakes and reservoirs were all higher than 50%. PARAFAC results showed that CDOM collected from the four lakes was composed of four fluorescent components, including a terrestrial humic-like C1, a tryptophan-like C2, and tyrosine-like C3 and C4. Protein-like components (C2, C3, and C4) contributed importantly to the CDOM pool in the four waterbodies, and in Lake Hongze the contribution of C2-C4 was as high as (90.0±2.2)%. In Lake Hongze, total phosphorus (TP) correlated closely with C1-C3, indicating that those components can be used to trace the variability of TP. Among the four waterbodies, a₂₅₄ was positively correlated with DOC (R²=0.96, P<0.01), indicating that a₂₅₄ can be used to estimate the dynamics of DOC in these waters. In Lake Taihu, we found a low level of humification index (HIX) and a high level of biological index (BIX), indicating that autochthonous substances contributed importantly to the CDOM pool in this lake. In comparison, allochthonous sources contributed importantly to the CDOM pool in the remaining three waters. The enhanced monitoring of the discharge of industrial and agricultural effluents in the upstream watersheds of the four waters can help to protect the water quality and maintain healthy aquatic ecosystems.

[Influences of Hydrological Scenarios on the Bioavailability, Fate, and Balance of Chromophoric Dissolved Organic Matter in Lake Poyang]

Lake Poyang has significant differences in hydrological characteristics between the flood and dry seasons. Unraveling the optical composition, bioavailability, fate, and balance of chromophoric dissolved organic matter (CDOM) and organic carbon fluxes in Lake Poyang under different hydrological conditions can help provide advanced schemes on carbon cycling, the transfer and transformation of organic matter, and water resource management of the lake. Three fluorescent components, including a humic-like (C1), a tryptophan-like (C2), and a tyrosine-like (C3) component, were obtained using three-dimensional fluorescence spectroscopy coupled with parallel factor analysis. Prior to and after 28 days of laboratory biodegradation, the means of a₂₅₄ and the terrestrial humic-like (C1) component in the flood season were both significantly higher than that in the dry season (t-test, P<0.01), indicating that the terrestrial humic-like (C1) component contributed importantly to the CDOM pool. The contribution percentages of protein-like components in the dry season were 81.7% of the summed fluorescent components of CDOM, indicating that there might be discharge of domestic wastewater from areas surrounding the lake in the dry season. The bioavailabilities of the humic-like (C1) component and DOC were 14.0% and 43.2%, respectively, in the dry season. This can be explained by a declined-dilution effect in the lake during the dry rather than in the flood season. We observed no significant difference in the bioavailability of protein-like components under different hydrological conditions. The bioavailability of C1 (i.e.,%ΔC1) showed a decreasing trend from the southern inflowing river mouths to the downstream northern outlet at Hukou in both the flood and dry seasons, indicating that the bioavailability of the C1 decreased following the migration of CDOM in the lake. In the dry season and flood season, Lake Poyang was the source of DOC with fluxes of 14.0×10³ t·mon^-1 and 1.4×10³ t·mon^-1, respectively, whereas CDOM fluxes in corresponding periods were the source and weak sink with corresponding fluxes of 9.3×10¹⁰ m³·(m·mon)^-1 and 1.1×10¹⁰ m³·(m·mon)^-1, respectively. Therefore, the lake released substantial organic matter to the downstream receiving waters during the dry season, whereas in the flood season, the higher water level in the Yangtze River resulted in a prolonged water residence time of the lake, and a fraction of CDOM was bio-degraded into inorganic nutrients, favoring the metabolisms and the eutrophication process of the lake ecosystem.

[Comparison of three kinds of free flaps used in patients with oral and oropharyngeal tumors]

Objective: To compare the recovery and quality of life of patients with oral and oropharyngeal tumors treated with three kinds of free soft tissue flaps. Methods: The clinical data of 103 patients, including 66 males and 37 females, aged 26-74 years, who underwent primary repair of defects after resection of oral and oropharyngeal tumors in Sichuan Tumor Hospital from July 2014 to August 2020 were analyzed. Anterolateral thigh flap (ALTF) was used in 43 patients, radial forearm free flap (RFFF) in 45 patients, and lateral arm free flap (LAFF) in 15 patients. Postoperative qualities of life of patients were evaluated by the university of Washington quality of life questionnaire and oral health impact scale (HIP-14 Chinese edition). SPSS 23.0 software was used for statistical analysis. Results: The T staging of RFFF or LAFF group was significantly lower than that of ALTF group (P<0.05). There was no significant difference in mean flap areas between ALTF group ((55.87±27.38) cm²) and LAFF group ((49.93±19.44) cm²), while RFFF group had smaller mean flap area ((33.18±6.05) cm²) than ALTF group (t=5.311, P<0.001) and LAFF group (t=3.284, P=0.005). In terms of oral functions including swallowing, mastication, taste and spitmouth, there were no significant differences between LAFF group and RFFF group (P>0.05), but both groups had better oral functions than ALTF group (P<0.05). There was no significant difference in appearance scores between LAFF group (75(75, 75)) and ALTF group (75(75,75) vs.75(75,75),Z=-1.532, P=0.126), and both groups had higher scores than RFFF group (50(50, 75),Z values were -3.447 and -3.005 respectively, P<0.05). RFFF group had higher speech score (100(67, 100)) than LAFF group (67(50, 76),Z=-2.480, P<0.05) and ALTF group (67(33, 67),Z=-5.414, P<0.05). ALTF group had lower mean score of quality of life than RFFF group [72(56,77) vs.79(69, 89),Z=-3.070, P<0.05), but there was no statistical difference in the mean scores of qualities of life between ALTF group and LAFF group (Z=1.754, P=0.079). According to the evaluation of oral health impact scale (HIP-14 Chinese version) 1 year after surgery, individual item scores and the average score of all items in ALTF group were lower than those in RFFF and LAFF groups (P<0.05), with no significant difference between RFFF group and LAFF group (P>0.05). Conclusions: RFFF has unique advantages for small tissue defects, while ALTF is suitable for large tissue defects, such as buccal penetrating defect, whole tongue and near whole tongue defect, and LAFF is a compromise choice between ALTF and RFFF. ALTF is inferior to RFFF and LAFF in oral functional reconstruction, including swallowing, chewing, taste and spittle. ALTF and LAFF are superior to RFFF in postoperative appearance.

[Sources and Optical Dynamics of Chromophoric Dissolved Organic Matter in Different Types of Urban Water Bodies]

In the past few decades, China's rapid industrial activities and urbanization processes have greatly impacted the urban surface water ecosystem. The changes in the quality of urban surface water directly affect the supply and carbon cycling of urban waters. We collected 50 water samples from urban rivers, lakes, and reservoirs in the city of Changchun in June 2020. Three-dimensional fluorescence spectroscopy coupled with parallel factor analysis (EEMs-PARAFAC) was used to unravel the optical characteristics, composition, and sources of chromophoric dissolved organic matter (CDOM). Our results indicated that the mean concentration of DOC is significantly higher in urban rivers than in reservoirs (t-test, P<0.05), and the mean UV absorption coefficient of CDOM a₂₅₄ of urban rivers is significantly larger than that of park lakes and reservoirs (t-test, P<0.05), indicating that urban rivers have the highest concentration of CDOM. The spectral slope of CDOM absorption S_275-295 and the spectral slope ratio S_R were shown to be higher in park lakes than in reservoirs, and even higher than in urban rivers (t-test, P<0.001). Three fluorescent components were obtained using PARAFAC, namely terrestrial human-like (C1), microbial human-like (C2) and tryptophan-like (C3) components. The mean fluorescence intensity of C1-C3 was significantly higher in urban rivers than in both the park lakes and reservoirs (t-test, P<0.005), and the mean fluorescence intensity of C1 in the reservoir water body was significantly higher than that of C2 and C3 (t-test, P<0.005), indicating that the discharge of municipal wastewater likely contributes significantly to the CDOM pool of urban rivers in Changchun, and the contribution percentages of highly bio-labile protein-like components to the CDOM pool in these waters are high. Urban wastewater treatment should be strengthened to effectively protect water quality, as well as the economic, environmental, and ecological functions of urban waters in Changchun City.

[Characterizing Sources and Composition of Chromophoric Dissolved Organic Matter in a Key Drinking Water Reservoir Lake Tianmu]

Lake Tianmu is an important source of drinking water, and its water quality can influence ecosystem service functions. Unraveling the sources and composition of chromophoric dissolved organic matter (CDOM) that can affect water treatment processes is necessary to maintain water supply safety and ecosystem service functioning of Lake Tianmu. Samples were collected monthly in 2017 and analyzed for CDOM absorbance and fluorescent spectra using parallel factor analysis (PARAFAC) to investigate the spatial and temporal variations of CDOM sources and composition in Lake Tianmu. PARAFAC results showed that CDOM in Lake Tianmu was mainly composed of a microbial humic-like component C1 (44.2%±9.8%), followed by a tryptophan-like component C2 (29.2%±4.3%), tyrosine-like component C3 (17.2%±13.1%), and terrestrial humic-like component, C4 was the lowest (9.4%±2.4%). The CDOM abundance a(254) and fluorescence intensities of C1 and C2 were significantly higher in the river mouths than in the downstream lake regions, whereas the spectral slope S_275-295 was significantly lower in the river mouths (t-test, P<0.05), indicating that allochthonous inputs cause an elevated degree of humification and relative increase in the molecular weight of CDOM in the inflowing river mouths. Seasonal differences in CDOM composition were mainly ascribed to the a(254) and fluorescence intensities of C1, C2, and C4 being significantly higher in the summer and autumn than in the winter and spring (t-test, P<0.05). Our results showed that the influences of different seasons on CDOM composition comprise differences in rainfall and runoff input, as well as water temperature, thermal stratification, phytoplankton biomass, and mineralization of CDOM by light and microbes.

[Posterior sternocleidomastoid border approach of gasless transaxillary endoscopic thyroidectomy in patients with papillary thyroid carcinoma: comparison with sternocleidomastoid fascia approach]

Objective: To examine the posterior sternocleidomastoid border approach which elevated whole sternocleidomastoid in gasless transaxillary endoscopic thyroidectomy. Methods: The clinical data of 46 patients with papillary thyroid carcinoma treated with gasless transaxillary endoscopic thyroidectomy from May 2019 to June 2020 at Department of Head and Neck Surgery, Sichuan Cancer Hospital was analyzed retrospectively. There were 9 males and 37 females, aged (38.6±12.0) years (range: 19 to 74 years). Fourteen and 32 cases performed posterior sternocleidomastoid border and sternocleidomastoid fascia approach, respectively. Comparative analysis were performed on clinical characters, surgical outcomes, postoperative complications, postoperative pain score, and quality-of-life of postoperative 1 month by t test, Wilcoxon rank sum test, Fisher exact test and χ2 test,respectively. Resuts Complete exposure of central compartment was higher (11/14 vs. 34.4%(11/32),χ²=7.624, P=0.006), more lymph nodes was retrieved (4.2±2.9 vs. 2.0±2.5, t=2.663, P=0.011) in posterior sternocleidomastoid border approach. There were no significant differences between groups in postoperative complications such as recurrent laryngeal nerve palsy (1/14 vs. 3.1%(1/32), P=0.521) and transient hypoparathyroidism (0 vs. 6.2%(2/32), P=1) and pains and quality-of-life. Conclusion: Posterior sternocleidomastoid border approach of gasless transaxillary endoscopic thyroidectomy is safe and reliable and has the advantage of central compartment dissection without increasing trauma.

[Molecular mechanism of zoledronic acid inhibiting angiogenesis by semi flexible binding with vascular endothelial growth factor conformation]

Objective: To study the relationship between zoledronic acid (ZOL) and vascular endothelial growth factor (VEGF) conformation so as to reveal the mechanism of bisphosphonates inhibiting angiogenesis. Methods: The binding structures of ZOL and VEGF were preprocessed and the molecular dockings were simulated through AutoDockTools, Discovery studio4 and AutoDockVina. The best binding conformation was accurately screened. The effects of various concentrations of ZOL (group A was 0 μmol/L, groups B, C and D were 25, 50 and 100 μmol/L, respectively) on human umbilical vein endothelial cell (HUVEC) proliferation, angiogenesis and angiogenic molecules were detected by using cell counting kit-8 (CCK-8) in vivo and in vitro angiogenesis, immunofluorescence and Western blotting. Results: There was a ZOL binding site on the target protein VEGF conformation. The affinity was -5.2 kcal/mol. This binding site consisted of the hydrophobic region composed of amino acids Cys26, 51, 57, etc. and the hydrogen bond binding region of the A chain (ASP34, SER50) and B chain (CYS61, 68, LEU66, GLY59). The results of CCK-8 showed that the levels of value A in groups B, C and D were significantly lower than that in group A at each time point from 3 to 6 days (P<0.05). In vitro vascular experiments demonstrated that the numbers of budding in groups B, C and D [(208±28), (151±21) and (62±9), respectively] were significantly lower than that in group A (276±30) (P<0.05). In vivo vascular experiments displayed that the ratio of Matrigel gel/plasma fluorescence in group A (0.003 1±0.000 3) was significantly higher than those in group B (0.002 1±0.000 2), group C (0.001 6±0.000 2) and group D (0.000 6±0.000 1) (P<0.05). The results of Western blotting revealed that the expression of VEGF in groups B, C and D [(0.72±0.11), (0.41±0.07) and (0.24±0.04), respectively] were significantly lower than that in group A (1.01±0.02) (P<0.05), and the expression levels of hypoxia-inducible factor-1α (HIF-1α) in groups B, C and D [(0.68±0.09), (0.55±0.06) and (0.43±0.08), respectively] were significantly lower than that in group A (0.96±0.04) (P<0.05). Conclusions: ZOL could inhibit cell proliferation, in vivo and in vitro vascularization and expression of VEGF/HIF-1α. The binding site of ZOL with the conformation of VEGF was located in the hydrophobic region and hydrogen-bonding region of amino acids. Designing an antagonist targeting this site might potentially alleviate the effect of ZOL in inhibiting angiogenesis.

New oxindole alkaloids with selective osteoclast inhibitory activity from Gelsemium elegans

A new alkaloid 14-hydroxygelseziridine (1), along with four known oxindoles (2-5), was isolated and characterized from the well-known toxic medicine Gelsemium elegans. Their structures were elucidated by means of spectroscopic techniques and quantum chemistry calculations. Structurally, new compound 1 has a three membered oxygen ring at N-4/C-20. All compounds were tested for osteoclast (MOC-1) inhibitory activity in vitro. Compound 2 exhibited the selective osteoclast inhibitory activity. Flow cytometry revealed that the apoptosis of osteoclasts induced by 2. Furthermore, the PCR bioassay suggested that compound 2 may activate the apoptotic pathway of osteoclasts by reducing the expression of IL-6 and c-Jun, and increasing caspase 9. This work provided the evidence for the rationality as the traditional treatment for bone related diseases of G. elegans, and shed a new light on its further research.

[Effect of Phytoplankton Community Composition and Size Structure on Light Absorption Properties]

In the fields of phytoplankton ecology, water optics, and water color remote sensing, phytoplankton absorption properties represent the light absorption capacity of phytoplankton, which affects photosynthesis efficiency and carbon fixation. Here, the biomass, community composition, and the absorption properties of phytoplankton were measured alongside other bio-optical parameters in Lake Tianmu are examined using data collected between January and November 2013 (except February). Based on the relationships between phytoplankton biomass, community composition, and absorption, the effects of abundance, biomass, and equivalent sphere diameter on phytoplankton absorption and specific absorption were revealed. The highest biomass and abundance of phytoplankton were recorded in the autumn and the lowest in the winter. Cryptomonas, Synedra, and Cyclotella were the dominant genera throughout the year. The dominant genera structure type was Bacillariophyta-Cryptophyta in the winter and spring, Bacillariophyta-Chlorophyta-Pyrroptata in the summer, and Cryptophyta-Bacillariophyta-Chlorophyta in the autumn. Phytoplankton diameter was ranked in the order summer>autumn>winter>spring, with mean values of 64.83 μm in summer and 29.54 μm in spring. Phytoplankton absorption coefficients of were ranked in the order autumn > spring > winter > summer, with mean values at 440 nm and 675 nm of (0.66±0.18) m^-1 and (0.33±0.10) m^-1 in autumn and (0.17±0.02) m^-1 and (0.08±0.01) m^-1 in summer, respectively. The specific absorption coefficients of the phytoplankton were ranked in the order spring > winter > autumn > summer, with mean values at 440 nm and 675 nm of (0.07±0.02) m²·mg^-1 and (0.04±0.01) m²·mg^-1 in spring and (0.03±0.004) m²·mg^-1 and (0.01±0.002) m²·mg^-1 in summer, respectively. Significant linear correlations were found between phytoplankton biomass, abundance, and absorption coefficients. Variations of Bacillariophyta and Cyanophyta biomass caused by temperature explained the seasonal variation in absorption coefficients. The specific absorption coefficient decreased with an increase in equivalent sphere diameter, and variations in phytoplankton community composition explained seasonal changes in the specific absorption coefficient.

Mitochondrial Iron Overload-Mediated Inhibition of Nrf2-HO-1/GPX4 Assisted ALI-Induced Nephrotoxicity

Aristolactam I (ALI) is an active component derived from some Traditional Chinese medicines (TCMs), and also the important metabolite of aristolochic acid. Long-term administration of medicine-containing ALI was reported to be related to aristolochic acid nephropathy (AAN), which was attributed to ALI-induced nephrotoxicity. However, the toxic mechanism of action involved is still unclear. Recently, pathogenic ferroptosis mediated lipid peroxidation was demonstrated to cause kidney injury. Therefore, this study explored the role of ferroptosis induced by mitochondrial iron overload in ALI-induced nephrotoxicity, aiming to identify the possible toxic mechanism of ALI-induced chronic nephropathy. Our results showed that ALI inhibited HK-2 cell activity in a dose-dependent manner and significantly suppressed glutathione (GSH) levels, accompanying by significant increases in intracellular 4-hydroxynonenal (4-HNE) and intracellular iron ions. Moreover, the ALI-mediated cytotoxicity could be reversed by deferoxamine mesylate (DFO). Compared with other inhibitors, Ferrostatin-1 (Fer-1), a ferroptosis inhibitor, obviously alleviated ALI-induced cytotoxicity. Furthermore, we have shown that ALI could remarkably increase the levels of superoxide anion and ferrous ions in mitochondria, and induce mitochondrial damage and condensed mitochondrial membrane density, the morphological characteristics of ferroptosis, all of which could be reversed by DFO. Interestingly, ALI dose-dependently inhibited these protein contents of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and glutathione peroxidase 4 (GPX4), which could be partly rescued by Tin-protoporphyrin IX (SnPP) and mitoTEMPO co-treatment. In conclusion, our results demonstrated that mitochondrial iron overload-mediated antioxidant system inhibition would assist ALI-induced ferroptosis in renal tubular epithelial cells, and Nrf2-HO-1/GPX4 antioxidative system could be an important intervention target to prevent medicine containing ALI-induced nephropathy.

Astragalus membranaceus root supplementation improves average daily gain, rumen fermentation, serum immunity and antioxidant indices of Tibetan sheep

The use of antibiotics as supplements in animal feed is restricted due to possible health hazards associated with them. Consequently, there is increasing interest in exploiting natural products to improve health and production of livestock with no detrimental side effects. In this study, we examined the effect of Astragalus membranaceus root (AMT) supplementation on DM intake, growth performance, rumen fermentation and immunity of Tibetan sheep. Twenty-four male Tibetan sheep (31 ± 1.4 kg; 9 months old) were assigned randomly to one of four dietary treatments with different levels of AMT: 0, 20, 50 and 80 g/kg DM (A₀, A₂, A₅ and A₈, respectively) in addition to their basal diets. A₀ acted as a control group, and measurements were recorded over a 56-d feeding period. Sheep fed with AMT had a higher average daily gain and a lower feed:gain ratio than controls (P < 0.001). Rumen concentrations of NH₃-N (P < 0.001), total volatile fatty acids (P = 0.028), acetate (P = 0.017) and propionate (P = 0.031) in A₅ and A₈ were higher than those in A₀. The addition of AMT in the feed significantly increased serum antioxidant and immunity factors of the sheep and increased the concentrations of serum interleukin, immunoglobulin and tumour necrosis factor-α (P = 0.010). We concluded that AMT can be used as a feed additive to improve growth performance and rumen fermentation and enhance the immunity of Tibetan sheep. Some responses exhibited a dose-dependent response, whereas other did not exhibit a pattern, with an increase in AMT. The addition of 50 and 80 g/kg AMT of total DM intake showed the most promising results.

[Practice guideline for patients with osteoporosis]

In recent years, osteoporosis (OP) has become one of the main diseases affecting the health of middle-aged and elderly people in China, and the prevalence of OP has increased significantly. The clinical diagnosis and treatment guidelines for this disease are also constantly updated. The overall principles speciallyemphasise that doctors and patients need to work together to negotiate the details of the diagnosis and treatment guidelines, in order to improve the OP clinical diagnosis and treatment rate. Therefore, patients' knowledge of the disease, understanding of clinical guidelines, and cooperation with doctors to implement diagnosis and treatment plans are very important. In this study, from the most concerned issues of the patients, we established the OP patient practice guideline working group. 14 recommendations, as the OP patient practice guidelines, are proposed in accordance with the relevant principles of the "World Health Organization guidelines development manual" and the international normative process.

Genus Alangium - A review on its traditional uses, phytochemistry and pharmacological activities

The species from Alangium have been used as folk medicine to treat rheumatism, skin diseases, diabetes by the people of Southeast Asia. Previous phytochemical studies have shown this genus are rich sources of alkaloids, glycosides, and terpenoids, which have attracted considerable attention of many researchers due to their markedly diverse and complex architecture. The crude extracts as well as the monomeric compounds from the title genus possess anti-tumor, anti-inflammatory, antibacterial, anti-oxidant pharmacological activities. Besides, some isolates from Alangium exhibited the effects on skeletal, smooth muscle and the nervous system. As a large genus of medicinal plants, the medicinal value of Alangium has been widely reported, but there is no review that provide a systematic summary towards its chemical constituents and pharmacological activities, to our knowledge. This work aims to present a comprehensive overview on the traditional uses, phytochemistry, and pharmacological activities of medicinal plants in the genus Alangium, and to explore the evidence supporting its ethnopharmacological effectiveness.

Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis

BACKGROUND

Bone morphogenetic proteins (BMPs) have strong bone induction properties and can promote healing of fractures and other defects. However, BMP treatment efficacy for long bone nonunion remains controversial. The aim of this meta-analysis was to synthetically evaluate the advantages and disadvantages of BMP plus bone grafting (observation group) versus autologous bone grafting (control group) for limb long bone nonunion.

METHODS

PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Weipu Journal, Chinese Biomedical Literature, and WanFang were searched for randomized and non-randomized controlled trials published before November 2019. A meta-analysis of outcome indicators was performed using RevMan 5.3 and Stata 12.0.

RESULTS

Five randomized and four non-randomized controlled trials involving 30-124 cases were included, with a total of 655 nonunion cases. There were no significant group differences in postoperative healing rate, infection, and secondary operation rates (P > 0.05), but the study group demonstrated significantly shorter mean healing time (WMD = - 1.27, 95%CI - 1.67 to - 0.88, P < 0.00001), a greater frequency of excellent/good post-treatment limb function (RR = 1.18, 95%CI 1.01-1.39, P = 0.04), and lower intraoperative blood loss (P < 0.05). Alternatively, the hospitalization cost was significantly higher in the study group (P < 0.01).

CONCLUSIONS

Bone morphogenetic protein is a viable alternative to autologous bone grafting, with potential advantages of accelerated fracture healing and improved postoperative function.

[Using the big data of internet to understand the characteristics of coronavirus disease 2019: a big data study]

Objective: To analyze the symptom characteristics of Coronavirus Disease 2019(COVID-19) and to improve its prevention by using big data. Methods: Using Baidu Index Platform (http://index.baidu.com) and the website of Chinese Center for Disease Control and Prevention as data resources, we obtained the search volume (SV) of keywords for symptoms associated with COVID-19 from January 1 to February 20 in each year from 2017 to 2020, in Hubei province and other top 10 impacted provinces in China and the epidemic data. Data of 2020 were compared with the previous three years. Data of Hubei province were compared with confirmed cases. The differences and characteristics of the SV of COVID-19-related symptoms, and the correlation between the SV of COVID-19 and new confirmed or suspected cases were analyzed and the hysteresis effects were discussed. R3.6.2 software was used to analyze the data. Results: Compared the data from January 1 to February 20, 2020, with the SV for the same period of previous three years, Hubei's SV for cough, fever, diarrhea, chest tightness, dyspnea and other symptoms were significantly increased. The total SV of lower respiratory symptoms was significantly higher than that of upper respiratory symptoms (P<0.001). The SV of COVID-19 in Hubei province was significantly correlated with new confirmed or suspected cases (r(confirmed)=0.723, r(suspected)=0.863, all P<0.001). The results of the distributed lag model suggested that the patients who retrieved relevant symptoms on the internet may begin to see a doctor in 2-3 days later and be diagnosed in 3-4 days later. Conclusions: The total SV of lower respiratory symptoms is higher than that of upper respiratory symptoms, and the SV of diarrhea also increases significantly. It warns us to pay attention to not only the symptoms of lower respiratory tract, but also the gastrointestinal symptoms, especially diarrhea in patients with COVID-19. There is a relationship between internet retrieval behavior and the number of new confirmed or suspected cases. Big data have a certain role in the early warning of infectious diseases.

Genotyping and characterization of Toxoplasma gondii strain isolated from pigs in Hubei province, central China

Toxoplasma gondii, a ubiquitous pathogen that infects nearly all warm-blooded animals and humans, can cause severe complications to the infected people and animals as well as serious economic losses and social problems. Here, one local strain (TgPIG-WH1) was isolated from an aborted pig fetus, and the genotype of this strain was identified as ToxoDB #3 by the PCR RFLP typing method using 10 molecular markers (SAG1, SAG2, alternative SAG2, SAG3, BTUB, GRA6, L358, PK1, C22-8, C29-2 and Apico). A comparison of the virulence of this isolate with other strains in both mice and piglets showed that TgPIG-WH1 was less virulent than type 1 strain RH and type 2 strain ME49 in mice, and caused similar symptoms to those of ME49 such as fever in piglets. Additionally, in piglet infection with both strains, the TgPIG-WH1 caused a higher IgG response and more severe pathological damages than ME49. Furthermore, TgPIG-WH1 caused one death in the 5 infected piglets, whereas ME49 did not, suggesting the higher virulence of TgPIG-WH1 than ME49 during piglet infection. Experimental infections indicate that the virulence of TgPIG-WH1 relative to ME49 is weaker in mice, but higher in pigs. This is probably the first report regarding a ToxoDB #3 strain from pigs in Hubei, China. These data will facilitate the understanding of genetic diversity of Toxoplasma strains in China as well as the prevention and control of porcine toxoplasmosis in the local region.

[Response of Chromophoric Dissolved Organic Matter Dynamics to Different Hydrological Scenarios in the Two Largest Freshwater Lakes Connected to the Yangtze River]

Poyang Lake and Dongting Lake are the two largest freshwater lakes in China connected to the Yangtze River. Changes in the water quality of the two lakes are critical to the water security of the residents surrounding the lakes. Analyses of the optical properties, including chromophoric dissolved organic matter (CDOM) absorption and fluorescence spectroscopy coupled by parallel factor analysis (PARAFAC), were carried out to investigate the dynamics of CDOM in the two lakes in different hydrological scenarios. Our results indicated that different hydrological scenarios have more notable effects on the CDOM dynamics in Poyang Lake compared to those in Dongting Lake. In Poyang Lake, the mean CDOM absorption a(254) and dissolved organic carbon (DOC) were higher in the wet season than in the dry-to-wet transition season, and higher still than in the dry season (t-test, P<0.01), and the mean of the CDOM absorption spectral slope S_275-295 was higher in the dry season than in the dry-to-wet transition season and higher still than in the wet season (t-test, P<0.01). In Dongting Lake, the mean of a(254) was not significantly different between different hydrological periods, and SUVA₂₅₄ reached its maximum in the dry-to-wet transition season. Four fluorescent components were identified using parallel factor analysis. The contribution percentage of CDOM protein-like components in the two lakes was higher during the dry season, and the protein-like components and humic-like components contributed roughly the same amount in the dry-to-wet season, whereas the humic-like components accounted for the main proportion in both lakes during the wet season. From the perspective of spatial distribution, the fluorescence intensity of the four components of Poyang Lake was lower in the southern upstream than in the northern downstream lake regions during the dry season, whereas in the wet season a contrast pattern was found, i.e., with high values found in the upstream lake regions. The spatial difference of fluorescence intensity of the four components in the east of Dongting Lake during the dry season was greater than that in the wet season. We found that DOC increased with increasing water level (r²=0.99, P<0.01) in Poyang Lake and tryptophan-like C2 decreased with increasing water level (r²=0.99, P<0.05) in Dongting Lake. Therefore, the water quality of the two lakes should be managed in a targeted manner according to the response characteristics of CDOM in the two lakes under different hydrological scenarios.

[Bioavailability Characteristics of Chromophoric Dissolved Organic Matter in Lake Gaoyou, Lake Nansi, and Lake Dongping Under Different Hydrological Scenarios]

The bio-lability of chromophoric dissolved organic matter (CDOM) directly reflects its biodegradability potential, and also affects the migration and conversion of pollutants and impacts water quality. This study combines excitation-emission matrices and parallel factor analysis (EEMs-PARAFAC) with laboratory 28 days of bio-incubation experiments, and analyzed the bioavailability characteristics of CDOM samples collected from Lake Gaoyou, Lake Nansi and Lake Dongping in flood season and dry season. Our results showed that:① four fluorescent components were obtained using EEMs-PARAFAC, including a microbial humic-like C1, a terrestrial humic-like C4, a tryptophan-like C2, and a tyrosine-like C3. ② The differences of CDOM absorption pre-and post-incubation, i.e. Δa(254) of the three lakes were positive in the three lakes in the flood season, while partially negative in the dry season, indicating a quite different response of CDOM bioavailability to hydrological seasons. ③ Under different hydrological scenarios, the two humic-like components C1 and C4 increased post-bio-incubation compared with that pre-incubation for the samples collected from Lake Nansi and Lake Dongping, and the two protein-like components in Lake Nansi in both the flood and dry seasons and in Lake Dongping in the flood season (t-test, P<0.001, P=0.005) were lower in the post-than those pre-incubation. In Lake Gaoyou, C1-C3 post-incubation were significantly lower than pre-incubation (t-test, P=0.008, P=0.005). In the dry season, in comparison, C1-C4 except for C2 increased post-incubation than pre-incubation for Lake Gaoyou. This indicated that the protein-like components are unstable and more easily uptaken by microorganisms and may be potentially converted into more stable humic-like components. HIX and I_C:I_T of the three lakes increased post-incubation while the spectral slope S_275-295 decreased, which further confirmed the aforementioned conclusion. ④ During both the flood and dry seasons, the bioavailability of the protein-like components C2-C3 and the fluorescence intensity of C1 and C4 in the inflowing river mouths of the three lakes were higher than in the remaining lake regions. It is therefore necessary to strengthen the water quality management in the inflowing river mouths of the three lakes to maintain the water quality of the lakes.

[Analysis of the first cluster of cases in a family of COVID-19 in Gansu Province]

The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.