Ultrasound-guided pacemaker implantation at the bedside: A lifesaving technique for cardiac emergencies.

OBJECTIVE: To investigate the safety and effectiveness of implanting temporary pacemakers using ultrasound-guidance at the bedside for rescuing patients in case of cardiac emergencies. METHODS: We enrolled 194 patients with cardiac emergencies requiring temporary pacemakers in this study, and randomly assigned them to either a bedside ultrasound-guided installation group or an electrocardiogram-guided installation group. There were 105 cases in the bedside ultrasound-guided installation group, aged approximately 66.3 ± 10.2 years, and 89 cases in the electrocardiogram-guided installation group, aged approximately 65.8 ± 9.5 years old, and disease composition was similar between the two groups. We then compared the duration of the procedure, success rates, and occurrence of adverse events between the two groups. RESULTS: The two groups showed similar clinical characteristics. The success rates of venipuncture and temporary pacemaker electrode placement were both 100% in the bedside ultrasound-guided installation group, compared to 87.8% and 96.7% respectively, in the electrocardiogram-guided installation group, with a statistically significant difference between the two groups. The duration of puncture was significantly shorter in the bedside ultrasound-guided installation group than in the electrocardiogram-guided installation group, with statistically significant differences. Moreover, no adverse events such as hematoma, pneumothorax and electrode dislodgement occurred in the bedside ultrasound-guided installation group, while 13 cases in the electrocardiogram-guided installation group experienced adverse events, and the difference was statistically significant. CONCLUSIONS: The bedside installation of temporary pacemakers using ultrasound guidance is a simple, safe, effective, and cost-efficient procedure that boasts a high success rate, does not involve radiation, and enables accurate placement of the electrode catheter.

Organic carbon preservation in wetlands: Iron oxide protection vs. thermodynamic limitation.

The sequestration of organic carbon (OC) in wetland sediments is influenced by the presence of oxygen or lack thereof. The mechanisms of OC sequestration under redox fluctuations, particularly by the co-mediation of reactive iron (Fe) protection and thermodynamic limitation by the energetics of the OC itself, remain unclear. Over the past 26 years, a combination of field surveys and remote sensing images had revealed a strong decline in both natural and constructed wetland areas in Tianjin. This decline could be attributed to anthropogenic landfill practices and agricultural reclamation efforts, which may have significant impacts on the oxidation-reduction conditions for sedimentary OC. The Fe-bound OC (CBD extraction) decreased by 2 to 10-fold (from 8.3 to 10% to 0.7-4.5%) with increasing sediment depth at three sites with varying water depths (WD). The high-resolution spectro-microscopy analysis demonstrated that Fe (oxyhydr)oxides were colocalized with sedimentary OC. Corresponding to lower redox potential, the nominal oxidation state of C (NOSC), which corresponds to the energy content in OC, became more negative (energy content increased) with increasing sediment depth. Taken together, the preservation of sedimentary OC is contingent on the prevailing redox conditions: In environments where oxygen availability is high, reactive Fe provides protection for OC, while in anoxic environments, thermodynamic constraints (i.e., energetic constraints) limit the oxidation of OC.

Safety and efficacy of levosimendan in patients with acute heart failure: a prospective, multicenter, and observational study / 中华急诊医学杂志

Objective:To investigate the indication, effectiveness, tolerance, and safety of levosimendan in patients with acute heart failure (AHF) in 20 hospitals in Beijing, China.Methods:This prospective, observational, and multicenter study consecutively enrolled AHF patients who were treated with levosimendan at 20 hospitals in Beijing from April 2020 to March 2022. Baseline demographics, laboratory parameters, clinical presentation, concomitant diseases and medications were collected. After initiation of levosimendan, levosimendan administration, laboratory parameter pre- and post-administration, symptoms improvement, and adverse events were also collected.Results:Totally 800 AHF patients were included, 67% of whom were male, aged (65 ±17) years, 50% of whom had ischemic heart disease, and the left ventricular ejection fraction (LVEF) was (36±11)%. The dose of levosimendan was (11.84 ±2.11) mg and the mean infusion time was (1 450±307) min. Dyspnea was improved in 83.4% of AHF patients at 24 h after treatment. The level of B-type natriuretic peptide (BNP) significantly decreased from 689 (406-1509) pg/mL to 410 (156-697) pg/mL in all patients at 24-72 h after treatment ( P<0.001), and the level of N-terminal pro-brain natriuretic peptide (NT-pro BNP) decreased from 6910 (3 715-13 914) pg/mL to 2 851 (1 288-6 191) pg/mL ( P<0.001). Meanwhile, LVEF level also improved significantly [(40±11)% vs. (36±11)%, P<0.001]. During levosimendan administration, adverse events occurred in 74 (9.3%) patients, including hypotension (5.9%), arrhythmia (1.9%), and other symptoms (1.1%). Among them, 7 patients ( 2 patients with hypotension and 5 patients with ventricular tachycardia) interrupted levosimendan administration. Conclusions:The use of levosimendan is safe, and can improve symptoms reduce BNP or NT-pro BNP levels and increase LVEF level in AHF patients.

Graph-Aware Language Model Pre-Training on a Large Graph Corpus Can Help Multiple Graph Applications.

Model pre-training on large text corpora has been demonstrated effective for various downstream applications in the NLP domain. In the graph mining domain, a similar analogy can be drawn for pre-training graph models on large graphs in the hope of benefiting downstream graph applications, which has also been explored by several recent studies. However, no existing study has ever investigated the pre-training of text plus graph models on large heterogeneous graphs with abundant textual information (a.k.a. large graph corpora) and then fine-tuning the model on different related downstream applications with different graph schemas. To address this problem, we propose a framework of graph-aware language model pre-training (GaLM) on a large graph corpus, which incorporates large language models and graph neural networks, and a variety of fine-tuning methods on downstream applications. We conduct extensive experiments on Amazon's real internal datasets and large public datasets. Comprehensive empirical results and in-depth analysis demonstrate the effectiveness of our proposed methods along with lessons learned.

Global airborne bacterial community-interactions with Earth's microbiomes and anthropogenic activities.

Airborne bacteria are an influential component of the Earth's microbiomes, but their community structure and biogeographic distribution patterns have yet to be understood. We analyzed the bacterial communities of 370 air particulate samples collected from 63 sites around the world and constructed an airborne bacterial reference catalog with more than 27 million nonredundant 16S ribosomal RNA (rRNA) gene sequences. We present their biogeographic pattern and decipher the interlacing of the microbiome co-occurrence network with surface environments of the Earth. While the total abundance of global airborne bacteria in the troposphere (1.72 × 1024 cells) is 1 to 3 orders of magnitude lower than that of other habitats, the number of bacterial taxa (i.e., richness) in the atmosphere (4.71 × 108 to 3.08 × 109) is comparable to that in the hydrosphere, and its maximum occurs in midlatitude regions, as is also observed in other ecosystems. The airborne bacterial community harbors a unique set of dominant taxa (24 species); however, its structure appears to be more easily perturbed, due to the more prominent role of stochastic processes in shaping community assembly. This is corroborated by the major contribution of surface microbiomes to airborne bacteria (averaging 46.3%), while atmospheric conditions such as meteorological factors and air quality also play a role. Particularly in urban areas, human impacts weaken the relative importance of plant sources of airborne bacteria and elevate the occurrence of potential pathogens from anthropogenic sources. These findings serve as a key reference for predicting planetary microbiome responses and the health impacts of inhalable microbiomes with future changes in the environment.

Two POM-based compounds containing Zn-capped Keggin anions as decent heterogeneous catalysts for sulfur oxidation and CO2 cycloaddition reactions.

Carbon dioxide (CO2) and the combustion of sulfide in gasoline are the main causes of air pollution. A great deal of attention has been paid to solving the problem and the catalytic reaction seems to be a decent choice. Due to the high-density of Lewis acidic active sites, polyoxometalates are undoubtedly an ideal choice for the sulfur oxidation reaction. With the reasons foregoing, two novel Zn-capped polyoxometalate-based organic-inorganic hybrids, {[α-PMoV2MoVI10O39(OH)Zn2][bbbm]3}·0.5C2H5OH (1) and TBA2{[ε-PMoV8MoVI4O37(OH)3Zn4][phim]3} (2) ((where bbbm = 1-(4-imidazol-1-ylbutyl) imidazole) and phim = 2-phenylimidazole) were successfully obtained by hydrothermal synthesis. In the two compounds, the N-donor ligands in a monodentate or bidentate coordination mode are directly connected to the Keggin anions by Zn-capped atoms, forming an extended one-dimensional chain. It is noteworthy that compound 2 ends up with an interesting spiral infinite chain possibly thanks to the TBA+ cations residing in gaps as structure-directing agents. Simultaneously, the catalytic properties indicate that compounds 1 and2 as efficient heterogeneous catalysts display a decent catalytic activity in the sulfur removal process. Especially, 2 enabled satisfying catalytic oxidation of dibenzothiophene (DBT) to produce more valuable dibenzothiophene sulfone (DBTO2) at 55 °C, and the conversion almost reached 99%. Besides, compound 2 also shows satisfactory catalytic effectiveness in the oxidation of various epoxides in the CO2 cycloaddition reaction, which suggests that compound 2 has the potential to function as a dual functional material with tremendous prospects in sulfur oxidation and carbon dioxide cycloaddition for the first time.

The predictive value of the CHA 2DS 2-VASc score for in-hospital outcomes in patients with acute myocardial infarction: China PEACE-retrospective acute myocardial infarction study / 中华内科杂志

Objectives:This study aimed to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital outcomes of patients with acute myocardial infarction (AMI). Methods:Data of 23 728 patients from the China patient-centered Evaluative Assessment of cardiac Events (China PEACE)Retrospective Acute Myocardial Infarction Study were analyzed retrospectively. The patients were categorized into 3 groups according to the CHA 2DS 2-VASc scores: the low score group (score 1-3), the middle score group (score 4-6) and the high score group (score 7-9). The in-hospital outcomes included major adverse cardiovascular events (MACE), death, death or withdrawal from treatment, reinfarction, ischemic stroke,etc. The CHA 2DS 2-VASc score was incorporated into multivariate Cox regression analyses to determine its independent impact on in-hospital outcomes. Receiver operating Characteristic (ROC) curves were constructed, and the area under the curve (AUC) was used to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital mortality and death or withdrawal from treatment, respectively. Results:The patients had a median age of 66 (56,75) years, and 30.7% of them were females. Patients with higher CHA 2DS 2-VASc scores had a higher in-hospital mortality and more in-hospital complications (all P<0.001). After adjustment of baseline covariates, the subjects in the high score group were associated with high risks of in-hospital mortality ( OR=6.13, 95% CI 4.77-7.87, P<0.001), death or treatment withdrawal ( OR=6.43, 95% CI 5.16-8.00, P<0.001) and MACE ( OR=4.94, 95% CI 4.06-6.01, P<0.001). The AUCs of the CHA 2DS 2-VASc score were comparable with those of the mini-global registry of acute coronary events(mini-GRACE)score in evaluation of in-hospital mortality (0.699 vs. 0.696, P=0.752) and the death or treatment withdrawal risk (0.708 vs. 0.713, P=0.489). Conclusions:The CHA 2DS 2-VASc score is an independent predictor of in-hospital outcomes for patients with AMI. Its predictive value was comparable with the mini-GRACE score, which could be used as a simple tool for early and rapid outcome evaluation for AMI patients.

Effect evaluation of PBL and LBL combined teaching method in teaching the skeletal motor system diseases / 中华医学教育探索杂志

Objective:To explore the effect of combined problem-based learning (PBL) and lecture-based learning (LBL) on the teaching of skeletal motor system diseases for eight-year clinical medicine program students.Methods:The clinical eight-year medical students from Batch 2014 and 2015 participating in the teaching of "osteoarthritis" in the course of Skeletal Motor System Diseases in West China Clinical Medical College of Sichuan University were divided into control group (60 students) and experimental group (82 students). The control group was taught by LBL teaching method, while the experimental group was taught by PBL+LBL teaching method. A questionnaire survey was conducted to retrospectively analyze the teaching effects, including learning enthusiasm, knowledge understanding, thinking ability, teamwork ability, practical ability, self-learning ability and teacher-student relationship, as well as the evaluation of teaching satisfaction. The SPSS 22.0 software was used for t test and chi-square test. Results:The survey results showed that students in the experimental group were significantly superior to those in the control group in such aspects as learning enthusiasm (8.00±1.61 vs. 7.28±1.98), knowledge understanding (8.02±1.59 vs. 7.33±1.79), thinking ability (8.34±1.66 vs. 7.42±1.90), teamwork ability (8.32±1.76 vs. 6.60±2.79), practical ability (7.70±1.69 vs. 6.87 ± 2.57), self-learning ability (8.05±1.65 vs. 7.35±2.48) and teacher-student relationship (7.96±1.75 vs. 7.25±2.10), with statistically significant differences ( P<0.05). Meanwhile, the PBL+LBL group was more satisfied with the teaching mode than the LBL group, and the difference was statistically significant ( P<0.05). Conclusion:The application of PBL+LBL teaching method in clinical medicine eight-year program course teaching of "osteoarthritis" in Skeletal Motor System Diseases can effectively improve the learning enthusiasm of students, improve the quality of education, and obtain good teaching effect.

A new family of boat-shaped Ln8 clusters exhibiting the magnetocaloric effect and slow magnetic relaxation.

Designing and synthesizing lanthanide clusters have always been a research hotspot. Herein, three lanthanide clusters with the formula [Ln8(IN)14(µ3-OH)8(µ2-OH)2(H2O)8]·xH2O (Ln = 1-Gd and x = 11; Ln = 2-Dy and x = 8; Ln = 3-Eu and x = 8) have been isolated in the presence of isonicotinic acid under solvothermal conditions. Structural analysis indicates that those three compounds are isostructural, featuring boat-shaped {Ln8} metal frameworks. Magnetic measurements reveal that 1-Gd exhibits a larger MCE with the maximum -ΔSm value of 31.77 J kg-1 K-1 at 2 K for ΔH = 7 T, while 2-Dy displays slow magnetization relaxation. Besides, the photoluminescence properties of 3-Eu were investigated.

Two Ni-Substituted Trilacunary Keggin-Type Polyoxometalates: Syntheses, Crystal Structures, NLO Studies, and Magnetic Properties.

Two Ni-substituted polyoxometalates (NiSPs), [Ni6(Py)6(H2O)5(µ3-OH)3(PW9O34)]2·10H2O (1), [Ni7(Py)6(Im)(H2O)5O(WO4)(µ3-OH)3(H2PW9O34)]·3H2O (2) (Py = pyridine, Im = imidazole), were successfully hydrothermally synthesized. Compounds 1 and 2 have significantly different configurations by introducing different amounts of imidazole ligands. For compound 1, two malposed {Ni6(Py)6PW9} units that are face to face are bridged by two Ni-O-W bonds to constitute an isolated dimeric structure. Differently, the {Ni7(Py)6(Im)PW9}2 dimer in compound 2 connects with four adjacent dimers by four {WO4} groups in an interesting two-dimensional (2-D) arrangement. The magnetism of compounds 1 and 2 was studied, and magnetic test results demonstrated that both compounds have ferromagnetic interactions between the nickel centers. Meanwhile, the third-order nonlinear optical (NLO) measurements indicated that compound 1 can serve as potential nonlinear optical materials.

Exploration and practice of developing top-notch innovative medical personnel based on research-oriented hospital with thick cultivation culture / 中华医学教育探索杂志

In response to the major national strategic needs of "Healthy China" and "Innovation-Driven Development", Sichuan University, as a pilot university of "Excellent Doctor Education and Training Plan-Top Innovative Medical Personnel Training", has been exploring the training strategies since 2012. On the basis of the international theory of "The Third Generation of Medical Education based on Health System", we have innovatively put forward the new era of "Med+" education theory based on research-oriented hospitals (with medical/research/translational facility) and the two-level training paradigm from "cultivating professionalism" to "notch up to top" by planting three cultures. We have also developed a competency training system of "Five Integrated Curricula and Five Teaching & Learning Strategies". We have shifted from "didactic teaching" to "formative learning", edifying excellent doctors with "professionalism culture". We have initiated two kinds of top-notch plans, constructed a "1+2+3" innovation and entrepreneurship education system, explored "transformative learning" to incubate compound top-notch personnel with "innovative culture", opened up a "school-hospital unified" administrative system, built a PDCA closed-loop of quality control supported by mobile technology, and recast the "quality culture" to ensure shifting from "cultivating professionalism" to "notch up to top".

Classification and reconstruction of complex defects after lateral facial tumor surgery / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the classification and reconstruction strategy of defects in lateral face region after operation of malignant tumors. Methods: Eighteen cases with the reconstruction of complicated defects after resection of tumors in the region of lateral face from January 2015 to January 2018 in Hunan Cancer Hospital were retrospectively reviewed. There were 14 males and 4 females, aged from 32 to 68 years. According to the presence or absence of bony scaffold, complicated defects were divided into two main categories: soft tissue perforating defects and soft tissue defects combined with bony scaffold defects. All soft tissue perforating defects in 5 cases were repaired with free anterolateral femoral flaps. Among 13 cases with soft tissue plus bony scaffold defects, 3 were repaired with free fibular flaps, 6 with free fibular flaps combined with free anterolateral femoral flaps, and 4 with chimeric deep circumflex iliac artery perforator flaps combined with anterolateral femoral flaps. Results: All flaps survived well. Two patients complicated with fistula in floor of mouth, but the wound healed after dressing change. Transoral feeding was resumed within 2 weeks after surgery in all patients. One year follow-up evaluation showed that 14 cases had symmetrical face and 10 cases had mouth opening more than 3 transverse fingers. After 36-50 months of follow-up, 6 patients died, with an overall 3-year survival rate of 66.7%. Conclusion: The classification of defects with or without bony stent loss is conducive to the overall repair design, the recovery of facial contour stent, the effective fill of dead space and the maintain of residual occlusal relationship. Good reconstruction results require a multi flap combination of osteocutaneous and soft tissue flaps.

Two new isolated Zn-ε-Keggin clusters modified by conjugated organic ligands with decent electrocatalytic and third-order NLO properties.

Two new bifunctional isolated hybrid compounds, [ε-PMoV8MoVI4O37(OH)3Zn4][iql]4·6H2O (1) and [ε-PMoV8MoVI4O38(OH)2Zn4][bipy]3[(CH3COO)(bipy)2Zn]·2H2O (2) (where iql = isoquinoline and bipy = 2,2'-bipyridine), based on Zn-ε-Keggin were successfully synthesized by self-assembly under hydrothermal conditions. It is interesting to note that acetate in 2 acted as a linker connecting the ε-Keggin anion with the one Zn atom (Zn5) and enabled the ε-Keggin anion to coordinate with more bipy ligands, culminating with a larger isolated system, which is the first reported isolated cluster of Zn5PMo12. Meanwhile, compounds 1-2 show great electrochemical behaviors and excellent electrocatalytic activity for the degradation of NaNO2. In addition, compound 2 displays better third-order NLO performance than 1 due to the presence of more conjugated rings, with a TPA cross section (σ) of 1819 GM, which suggests that compound 2 has the potential to function as a bifunctional material with tremendous prospects.

Effect of Adjuvant Paclitaxel and Carboplatin on Survival in Women With Triple-Negative Breast Cancer: A Phase 3 Randomized Clinical Trial.

Importance: The value of platinum-based adjuvant chemotherapy in patients with triple-negative breast cancer (TNBC) remains controversial, as does whether BRCA1 and BRCA2 (BRCA1/2) germline variants are associated with platinum treatment sensitivity. Objective: To compare 6 cycles of paclitaxel plus carboplatin (PCb) with a standard-dose regimen of 3 cycles of cyclophosphamide, epirubicin, and fluorouracil followed by 3 cycles of docetaxel (CEF-T). Design, Setting, and Participants: This phase 3 randomized clinical trial was conducted at 9 cancer centers and hospitals in China. Between July 1, 2011, and April 30, 2016, women aged 18 to 70 years with operable TNBC after definitive surgery (having pathologically confirmed regional node-positive disease or node-negative disease with tumor diameter >10 mm) were screened and enrolled. Exclusion criteria included having metastatic or locally advanced disease, having non-TNBC, or receiving preoperative anticancer therapy. Data were analyzed from December 1, 2019, to January 31, 2020, from the intent-to-treat population as prespecified in the protocol. Interventions: Participants were randomized to receive PCb (paclitaxel 80 mg/m2 and carboplatin [area under the curve = 2] on days 1, 8, and 15 every 28 days for 6 cycles) or CEF-T (cyclophosphamide 500 mg/m2, epirubicin 100 mg/m2, and fluorouracil 500 mg/m2 every 3 weeks for 3 cycles followed by docetaxel 100 mg/m2 every 3 weeks for 3 cycles). Main Outcomes and Measures: The primary end point was disease-free survival (DFS). Secondary end points included overall survival, distant DFS, relapse-free survival, DFS in patients with germline variants in BRCA1/2 or homologous recombination repair (HRR)-related genes, and toxicity. Results: A total of 647 patients (mean [SD] age, 51 [44-57] years) with operable TNBC were randomized to receive CEF-T (n = 322) or PCb (n = 325). At a median follow-up of 62 months, DFS time was longer in those assigned to PCb compared with CEF-T (5-year DFS, 86.5% vs 80.3%, hazard ratio [HR] = 0.65; 95% CI, 0.44-0.96; P = .03). Similar outcomes were observed for distant DFS and relapse-free survival. There was no statistically significant difference in overall survival between the groups (HR = 0.71; 95% CI, 0.42-1.22, P = .22). In the exploratory and hypothesis-generating subgroup analyses of PCb vs CEF-T, the HR for DFS was 0.44 (95% CI, 0.15-1.31; P = .14) in patients with the BRCA1/2 variant and 0.39 (95% CI, 0.15-0.99; P = .04) in those with the HRR variant. Safety data were consistent with the known safety profiles of relevant drugs. Conclusions and Relevance: These findings suggest that a paclitaxel-plus-carboplatin regimen is an effective alternative adjuvant chemotherapy choice for patients with operable TNBC. In the era of molecular classification, subsets of TNBC sensitive to PCb should be further investigated. Trial Registration: ClinicalTrials.gov Identifier: NCT01216111.

Research on innovative training model of medical undergraduate talents combining teaching and research / 中华医学教育探索杂志

The combination of teaching and research is an innovative training mode of medical undergraduate education in the new era, which aims to play the interaction of teaching with research, and promote this model while driving the innovation of the curriculum teaching system, thus propelling the medical undergraduate education in China to a new level. On the premise that basic teaching is fully guaranteed, in order to better construct and popularize the innovative mode, students, teachers and schools need to communicate and integrate repeatedly, and carry out the innovation training of scientific research throughout the whole process of medical undergraduate education. Students need to establish correct research values, teachers should renew their educational concepts and improve their sense of responsibility during the training of innovative medical undergraduate talents, and schools need to strengthen the supervision of students' scientific research and innovation activities and continuously improve relevant systems.

Evaluation of the current situation of English courses in eight-year M.D. program and prospect of reform — taking Sichuan University as an example / 中华医学教育探索杂志

Objective:To investigate the current situation and underlying problems of English courses in general education for eight-year M.D. Program and to put forward possible solutions.Method:s We investigated and interviewed teachers from West China Medical Center who teaches bilingual courses and teachers from College of Foreign Languages and Cultures along with faculty in Education Ministry of Sichuan University, analyzed the problems in English courses and explored measures for improvement.Result:s The emphasis students put on English course is satisfactory, but teachers still claim that few students participate actively in class. Therefore, the efficiency of English course should be improved.Conclusion:The current status of English course is not ideal, which can be attributed to both teachers and students, so future schemes should be based on these two perspectives.

[Effects of freeze-thaw and soil moisture on content and spectral structure properties of dissolved organic matter in forest soil leachates.] / å†»èžæ¡ä»¶å’ŒåœŸå£¤æ¹¿åº¦å¯¹æ£®æž—åœŸå£¤æ¸—æ¼æ¶²æº¶è§£æ€§æœ‰æœºè´¨å«é‡ä¸Žå ‰è°±ç»“æž„ç‰¹å¾çš„å½±å“.

The contents and stability of soil dissolved organic matter (DOM) can affect key processes of soil carbon and nitrogen cycle. The responses of DOM content and its spectral structure pro-perties in forest soils to climate change remain unclear. We collected soil samples from two temperate forests, i.e., the broadleaf and Korean pine mixed forest (BKPF) and adjacent secondary white birch forest (WBF), in Changbai Mountains, northeastern China. Using a combination of three-dimensional fluorescence spectrum and parallel factor analysis, a simulated freeze-thaw experiment was conducted in the laboratory. We examined the effects of freeze-thaw intensity, freeze-thaw cycle and their interaction on the content, components and spectral properties of DOM leached from the two forest surface soils with different moisture levels. The results showed that DOM content and components of soil leachates varied with forest types, soil moisture, freeze-thaw intensity and freeze-thaw cycle. The DOM content in the leachates was lowest at medium moisture level and was significantly affected by the high freeze-thaw intensity. In addition, the DOM content increased first and then decreased with the increases of freeze-thaw cycles. Three fluorescence components of DOM in the forest soil leachates were identified as humic acid-like DOM, fulvic acid-like DOM and protein-like DOM. The DOM components of BKPF soil leachates were mainly consisted of fulvic acid-like substances with a high humification index. However, the DOM from WBF soil leachates was dominated by humic acid-like substances with low stability, and the three fluorescence components were significantly affected by the freeze-thaw intensity. Results from the redundancy analysis showed that under the experimental conditions, forest type played a leading role in changing DOM properties. The DOM content and its three fluorescence intensities of WBF soil leachates were higher than those of BKPF. Soil moisture significantly affected the aromaticity of DOM in the forest soil leachates, and the DOM aromaticity of soil leachates from the two forest stands ranked as medium moisture > high moisture > low moisture. With the increases of freeze-thaw intensity, the DOM aromaticity of BKPF soil leachates significantly decreased. Furthermore, the increases of freeze-thaw cycles significantly increased the humification degree of DOM in the forest soil leachates. Therefore, upon different freeze-thaw disturbance, the DOM content and bioavailability of soil leachates with low moisture tended to increase, particularly in the WBF soil leachates, which may result in an increased lea-ching of DOM in temperate forest soils during spring freeze-thaw periods. The results provide a refe-rence for further investigating DOM turnover in temperate forest soils during spring freeze-thaw periods.

Pathways and Associations between Women's Land Ownership and Child Food and Nutrition Security in Pakistan.

Women's land ownership plays a noteworthy role in improving various development indicators, including her own wellbeing and children's food and nutrition security. However, the literature linking women's access to land rights to the nutritional security of children in Pakistan is limited, even though it is a country facing enormous challenges of childhood malnutrition and gender discrimination. This paper contributes to the existing literature on the benefits of empowering women by studying the association and pathways between women's land rights and child nutrition, using the 2012-2013 Pakistan Demographic and Health Survey. The ordinary least squares (OLS) regression results indicate that women's individual land ownership and women's autonomy in large-scale family purchases have a positive impact on children's food and nutrition security (FNS). The results of quantile regression (QR) show that these effects are more pronounced in cases of children with severe stunted growth. In addition, a structural equation model shows that the positive relationship between women's land ownership and child nutrition is partially mediated by women's increased decision-making power in large-scale household purchases. Our research concludes that ensuring women's land rights can improve women's autonomy, which can be an effective policy tool that not only improves women's welfare but also improves their children's nutritional security.

[Analysis and consideration based on first classical prescriptions].

Classical prescriptions are precious wealth left by ancient Chinese medical scientists. Moreover,they are also the important part of the treasure-house in Chinese medicine. Classical prescriptions have a long and rich history for human-use in China and play an important role in keeping people healthy. The state administration of traditional medicine of China published the Catalogue of Classical Prescriptions(first batch) in 2018. This measure has inspired the enthusiasm of Chinese medicine manufacturers to study ancient classical prescriptions and develop classical compound prescriptions. Based on the first batch of classical prescriptions, the dosage forms, sources, prescription components, decocting degree, use of toxic drugs and processing methods of classical prescriptions. The results showed that most of the classical prescriptions in the first batch were decoction and boiled powder,while only four of them were powder and paste forms,all of which were originated from representative classics in the past dynasties. The dosage and decocting degree of decoction were greater than those of boiled powder. The dosage and decocting degree of decoction in Han and Tang Dynasties was close to that in Ming and Qing Dynasties,higher than that in Song and Jin Dynasties. Moreover,the average number of herbs in the prescriptions in Han Dynasty was the smallest. The use of toxic traditional Chinese medicine was the most frequent in Han Dynasty, and Pinellia ternata was the most common toxic medicine. There were various processing methods, including cleansing, cutting, stir-frying, roasting and so on. In this paper, the dosage forms of traditional paste, the time concept of decoction in the ancient times, the traditional roasting method and the processing method of toxic drugs were summarized to provide ideas and reference for further development of classical prescriptions.

Preparation and quality evaluation of levocarnitine thermosensitive in situ gel / 药学学报

In this paper, a new type of preparation for treatment of initial dry eye disease, thermosensitive in situ gel, was prepared using levocarnitine as a model drug. Poloxamer 407 and poloxamer 188 were used as the gel matrix, and sodium hyaluronate and sodium carboxymethylcellulose were used as bioadhesive materials. Gelation temperature was determined by a rotor method and the prescription was optimized by central composite design-response surface methodology. The pH value, viscosity value and gelation temperature of the optimal prescription were measured. The release of the drug in vitro was examined by dialysis membrane permeation, and retention time of the thermosensitive in situ gel preparation on the rabbit's ocular surface was observed by a slit lamp microscope. The results showed that the dosage of the poloxamer 407 and poloxamer 188 were 20.81% and 3.46%, respectively, and sodium hyaluronate was 0.02%, sodium carboxymethyl cellulose was 0.10% of the optimal formulation of levocarnitine thermosensitive in situ gel. The pH value was 6.90 ± 0.06 at room temperature and the viscosity value started to rise sharply at 27 ℃ of the optimal formulation. The gelation temperature of the optimal preparation before and after dilution by simulated tear fluid were (26.37 ± 0.06) ℃ and (33.57 ± 0.21) ℃, respectively. In the first 240 min, in vitro release rate per unit area of levocarnitine thermosensitive in situ gel was lower than that of solution (P<0.05), and after 600 min, the cumulative release rate of levocarnitine thermosensitive in situ gel could reach more than 80%. The retention time of the thermosensitive in situ gel preparation on rabbit's ocular surface reached about 25 min, at least 5 times as much as that of the solution. The animal experiment was conducted following the National Institutes of Health Guidelines for the use of experimental animals, and approved by the Ethics Committee of the Experimental Animal Center of Beijing University of Chinese Medicine. The levocarnitine thermosensitive in situ gel showed good characteristics and sustained release property and significantly improved the retention time of the drug on the rabbit's ocular surface.