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Danggui Buxue Decoction is a classic formula for replenishing qi and nourishing blood. Despite its widespread use, its dynamic metabolism involved remains unclear. Based on the sequential metabolism strategy, blood samples from different metabolic sites were obtained via in situ closed intestine ring integrated with a jugular venous continuous blood supply technique. An ultra‐high‐performance liquid chromatography‐linear triple quadruple‐Orbitrap‐tandem mass spectrometry method was developed for the identification of prototypes and metabolites in rat plasma. The dynamic absorption and metabolic landscape of flavonoids, saponins, and phthalides were characterized. Flavonoids could be deglycosylated, deacetylated, demethylated, dehydroxylated, and glucuronicated in the gut and then absorbed for further metabolism. Jejunum is an important metabolic site for saponins biotransformation. Saponins that are substituted by Acetyl groups tend to lose their acetyl groups and convert to Astragaloside IV in the jejunum. Phthalides could be hydroxylated and glucuronidated in the gut and then absorbed for further metabolism. Seven components serve as crucial joints in the metabolic network and are potential candidates for the quality control of Danggui Buxue Decoction. The sequential metabolism strategy described in this study could be useful for characterizing the metabolic pathways of Chinese medicine and natural products in the digestive system. [ABSTRACT FROM AUTHOR]

Understanding the epidemiology of long COVID and emerging variants has significant public-health implications as physical interventions and restrictions that help limit viral spread are eased globally. Here, we provide rationales for the necessity of updating current vaccines to improve protection against omicron and emerging variants, as well as more research into understanding the epidemiology and mechanisms of long COVID. [ABSTRACT FROM AUTHOR]

Objective To use the high-performance liquid chromatography (HPLC) method and desorption electrospray ionization-mass spectrometry imaging (DESI-MSI) method to study the dynamic accumulation and distribution of secondary metabolites of Coptis chinensis in different growth years. Methods Using the samples of one-, three-, and five-year Coptis chinensis as the research object, the HPLC method was used to determine the contents of seven index components (jatrorrhizine hydrochloride, columbamine, epiberberine, coptisine hydrochloride, palmatine hydrochloride, berberine hydrochloride, and magnoflorine) as the secondary metabolites of Coptis chinensis. Further, the distribution of seven index components in the one-, three- and five-year Coptis chinensis slices were qualitatively analyzed by using the DESI-MSI method. Results The HPLC result showed that the contents of berberine hydrochloride and palmatine hydrochloride, jatrorrhizine hydrochloride, columbamine, and magnoflorine in five-year Coptis chinensis were the highest; coptisine hydrochloride and epiberberine reached the highest level in 3- year Coptis chinensis, while the contents of magnoflorine and jatrorrhizine hydrochloride were the lowest in three-year Coptis chinensis; and berberine hydrochloride, palmatine hydrochloride, columbamine, epiberberine, and coptisine hydrochloride were the lowest in one-year Coptis chinensis. The hydrochloride of each alkaloid was dissociated in the process of mass spectrometry and appeared in the prototype form. The result obtained by the DESI-MSI method show that berberine and epiberberine were concentrated in the whole-slices section, the distribution area of the one-year sample was the smallest, and the distribution areas of the three- and five-year samples were similar. Jatrorrhizine and columbamine were distributed in the phloem and pith, and the five-year sample distribution area was the largest; palmatine and coptisine were distributed in the phloem and pith, and the one-year sample distribution area was the smallest. Magnoflorine was only distributed in the wood, and the distribution areas in the one-, three-, and five-year Coptis chinensis were similar. Conclusion The accumulation of secondary metabolites in the one-year samples was the least, indicating that the first year is the main stage of the growth and development of Coptis chinensis. The accumulation of secondary metabolites of three-year samples was higher than those of the one-year sample, indicating that the following one to two years are the main stage for the accumulation of secondary metabolites of Coptis chinensis. The five-year plant sample had the highest content of total components, and berberine accumulated the most, which is consistent with the market usage rules of Coptis chinensis being cultivated for at least five years. [ABSTRACT FROM AUTHOR]

Canadian lung transplant centers currently use a subjective and dichotomous "Status" ranking to prioritize waitlisted patients for lung transplantation. The lung allocation score (LAS) is an objective composite score derived from clinical parameters associated with both waitlist and post‐transplant survival. We performed a retrospective cohort study to determine whether clinical judgment (Status) or LAS better predicted waitlist mortality. All adult patients listed for lung transplantation between 2007 and 2012 at three Canadian lung transplant programs were included. Status and LAS were compared in their ability to predict waitlist mortality using Cox proportional hazards models and C‐statistics. Status and LAS were available for 1122 patients. Status 2 patients had a higher LAS compared to Status 1 patients (mean 40.8 (4.4) vs 34.6 (12.5), P =.0001). Higher LAS was associated with higher risk of waitlist mortality (HR 1.06 per unit LAS, 95% CI 1.05, 1.07, P <.001). LAS predicted waitlist mortality better than Status (C‐statistic 0.689 vs 0.674). Patients classified as Status 2 and LAS ≥ 37 had the worst survival awaiting transplant, HR of 8.94 (95% CI 5.97, 13.37). LAS predicted waitlist mortality better than Status; however, the best predictor of waitlist mortality may be a combination of both LAS and clinical judgment. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.