Identification and Expression Pattern of Salvia miltiorrhiza Terpenoid Synthase Gene Family / 中国实验方剂学杂志

ObjectiveBioinformatics methods were used to systematically identify the Salvia miltiorrhiza terpenoid synthase （SmTPS） gene family members and predict their functions from the perspective of the genome. MethodThe genome and transcriptome data of S. miltiorrhiza， Arabidopsis thaliana， and tomato were obtained from the national genomics data center （NGDC）， national center for biotechnology information （NCBI）， the Arabidopsis information resource （TAIR）， and tomato functional genomics database （TFGD）， and the whole genome identification and bioinformatics analysis of the SmTPS gene family member were carried out with the help of Perl language programming， Tbtools， and other bioinformatics tools. ResultA total of 52 TPS gene family members were identified， and they were distributed on eight chromosomes of S. miltiorrhiza. Their coding amino acid number was 207-822 aa. The isoelectric points were 4.76-9.16. The molecular mass was 24.11-94.81 kDa， and all members are hydrophilic proteins. Gene structure analysis showed that there were significant differences in the number of introns among different subfamilies. The number of introns in 72.6% of TPS-a， b， and g subfamilies was 6， and that in 88.9% of TPS-c and e/f subfamilies was more than 10. Protein motifs were conserved among TPS subfamilies. The analysis of promoter cis-acting elements showed that all promoters of the SmTPSs contained a large number of light-responsive elements， and most of them had hormone-responsive elements. Gene expression analysis showed that SmTPS gene family members exhibited tissue-specific expression， and 24 of them responded to exogenous methyl jasmonate. ConclusionBased on the published S. miltiorrhiza genome， 52 SmTPS gene family members were identified， and their functions were predicted based on the phylogenetic analysis and expression patterns. This paper provides reference information for the further biosynthesis pathway and regulatory mechanism analysis of terpenoids in S. miltiorrhiza.

Chemical constituents of roots of Rodgersia aesculifolia / 中国中药杂志

The chemical compositions of Rodgersia aesculifolia were isolated and purified using a combination of silica gel, reverse phase silica gel, Sephadex LH-20 column chromatography, and semi-preparative HPLC. The structures were determined according to the physicochemical properties and spectroscopic data. The MTT method and the ABTS kit were used to measure the cytotoxicity and antioxidant capacity of all isolates, respectively. Thirty-four compounds were isolated from R. aesculifolia and elucidated as stigmastane-6β-methoxy-3β,5α-diol(1), stigmastane-3β,5α,6β triol(2), β-sitosterol(3), β-daucosterol(4), stigmast-4-en-3-one(5), bergenin(6), 11-β-D-glucopyranosyl-bergenin(7), 11-O-galloybergenin(8), 1,4,6-tri-O-galloyl-β-D-glucose(9), gallic acid(10), 3,4-dihydroxybenzoic acid methyl ester(11), ethyl gallate(12), ethyl 3,4-dihydroxybenzoate(13), caffeic acid ethyl ester(14), p-hydroxybenzeneacetic acid(15), 4-hydroxybenzoic acid(16), 2,3-dihydroxy-1-(4-hydroxy-3-methoxyphenyl)-propan-1-one(17), 3,7-dimethyl-2-octene-1,7-diol(18), crocusatin-B(19), neroplomacrol(20), geniposide(21), 3-hydroxyurs-12-en-27-oic acid(22), 3β-trans-p-coumaroyloxy-olean-12-en-27-oic acid(23), aceriphyllic acid G(24), isolariciresinol(25), trans-rodgersinine B(26), cis-rodgersinine A(27), neo-olivil(28),(7S,8R)-dihydro-3'-hydroxy-8-hydroxy-methyl-7-(4-hydroxy-3-methoxy phenyl)-1'-benzofuranpropanol(29), 5,3',4'-trihydroxy-7-methoxyflavanone(30), quercetin 3-rutinoside(31), catechin-[8,7-e]-4β-(3,4-dihydroxy-phenyl)-dihydro-2(3H)-pyranone(32), ethyl α-L-arabino-furanoside(33), and l-linoleoylglycerol(34). One new compound was discovered(compound 1), 25 compounds were first isolated from R. aesculifolia, and 22 compounds were first isolated from the Rodgersia plant. The results indicated that compounds 22-24 possessed cytotoxicity for HepG2, MCF-7, HCT-116, BGC-823, and RAFLS cell lines(IC_(50) ranged from 5.89 μmol·L~(-1) to 20.5 μmol·L~(-1)). Compounds 8-14 and 30-32 showed good antioxidant capacity, and compound 9 showed the strongest antioxidant activity with IC_(50) of(2.00±0.12) μmol·L~(-1).

Improvement of high-quality evaluation criteria of Chinese patent medicines based on whole process control / 中国中药杂志

Chinese patent medicines(CPMs) are unique therapeutic drugs in China. Establishing and improving the evaluation criteria is an important measure to promote the high-quality development of CPMs. Based on the "evaluation criteria of high-grade CPMs with quality as the core index" established by our group in 2018, the "high-quality evaluation criteria for CPMs based on whole process control" was proposed in the present study in 2022. The scope of application and basic principles of the new criteria were clarified. A quality evaluation scoring table was established in the new criteria, including five parts: raw material selection, production process, quality control, efficacy evaluation, and brand building. The technical evaluation indexes involved have increased from 20% in the original criteria to 70% in the new criteria, and efficacy evaluation has been added in the new criteria. The subjective evaluation indicators account for a large proportion in the original criteria, which is prone to bias. The improved criteria overcome this shortcoming. It is expected that the new criteria as a basis can play a better role in the selection of high-quality products of CPMs, guide enterprises and institutions to participate actively in the evaluation and research of high-quality CPMs, and promote the high-quality development of CPMs.

Rapid identification of components in Wuzhuyu Decoction using UHPLC Q-Exactive Orbitrap MS~n and molecular network technology / 中国中药杂志

Wuzhuyu Decoction, the classical formula recorded in the Treatise on Febrile Diseases(Shang Han Lun), has been included in the Catalogue of Ancient Classic Prescriptions(the First Batch). Consisting of Euodiae Fructus, Ginseng Radix et Rhizoma, Zingiberis Rhizoma Recens, and Jujubae Fructus, it is effective in warming the middle, tonifying deficiency, dispelling cold, and descending adverse Qi, and is widely applied clinically with remarkable efficacies. For a classical formula, the chemical composition is the material basis and an important premise for quantity value transfer. This study aimed to establish a rapid identification method of chemical components in Wuzhuyu Decoction by high-resolution mass spectrometry(HR-MS) and molecular network. AQUITY UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 μm) was used for sample separation, and acetonitrile-0.1% formic acid in water was used as mobile phases for gradient elution. Q-Exactive Orbitrap MS data were collected in positive and negative ion modes, and GNPS molecular network was plotted according to the similarity of MS/MS fragmentation modes. Cytoscape 3.6.1 was used to screen molecular clusters with similar structures. Finally, the chemical components of Wuzhuyu Decoction were rapidly identified according to the controls, as well as the information of retention time, accurate relative molecular weight of HR-MS, and MS/MS multistage fragments. A total of 105 chemical components were identified in Wuzhuyu Decoction. This study can provide data for the follow-up quality control, standard substance research, and pharmacodynamic material research on Wuzhuyu Decoction, as well as references for the rapid qualitative analysis of the chemical components of Chinese medicine.

Problem Analysis and Standard Establishment of Grade Evaluation Method of Traditional Chinese Medicine Decoction Pieces / 中国实验方剂学杂志

High quality is the premise for the implementation of high quality and good price for decoction pieces， and grade is the most direct manifestation of high quality of decoction pieces. However， there is still a lack of scientific and reasonable methods for evaluating the grade of decoction pieces， and it is urgent to establish a widely recognized and unified standard for the grade of decoction pieces to ensure the quality of the decoction pieces and guarantee the safety and efficacy of clinical use. Based on this， this paper focused on analyzing the problems of the current grade evaluation methods， such as unclear distinction between quality standards and grade standards， unreasonable selection of grade evaluation indicators， and inaccurate application of mathematical statistical methods. Based on the analysis of the grade evaluation of decoction pieces， this paper proposed four criteria for establishing the grade evaluation method of decoction pieces， namely universality， comprehensiveness， reliability and convenience， in order to establish a more reasonable and unified grade standard for decoction pieces and promote the quality improvement of decoction pieces and the development of the industry.

Identification of Chinese Herb Pieces Based on YOLOv4 / 中国实验方剂学杂志

Chinese herbal piece is an important component of the traditional Chinese medicine （TCM） system， and identifying their quality and grading can promote the development and utilization of Chinese herbal pieces. Utilizing deep learning for intelligent identification of Chinese herbal pieces can save time， effort， and cost， while also reasonably avoiding the constraints of human subjectivity， providing a guarantee for efficient identification of Chinese herbal pieces. In this study， a dataset containing 108 kinds of Chinese herbal pieces （14 058 images） was constructed，the basic YOLOv4 algorithm was employed to identify the 108 kinds of Chinese herbal pieces of our database The mean average precision （mAP） of the developed basic YOLOv4 model reached 85.3%. In addition， the receptive field block was introduced into the neck network of YOLOv4 algorithm， and the improved YOLOv4 algorithm was used to identify Chinese herbal pieces. The mAPof the improved YOLOv4 model achieved 88.7%， the average precision of 80 kinds of decoction pieces exceeded 80%， the average precision of 48 kinds of decoction pieces exceeded 90%. These results indicate that adding the receptive field module can help to some extent in the identification of Chinese herbal medicine pieces with different sizes and small volumes. Finally， the average precision of each kind of Chinese herbal medicine piece by the improved YOLOv4 model was further analyzed. Through in-depth analysis of the original images of Chinese herbal medicine pieces with low prediction average precision， it was clarified that the quantity and quality of original images of Chinese herbal medicine pieces are key to performing intelligent object detection. The improved YOLOv4 model constructed in this study can be used for the rapid identification of Chinese herbal pieces， and also provide reference guidance for the manual authentication of Chinese herbal medicine decoction pieces.

Investigation of Pretreatment Methods for Comprehensive Resource Utilization of Magnoliae Officinalis Cortex Dregs / 中国实验方剂学杂志

ObjectiveTo explore the pretreatment methods to promote the enzymatic digestion and extraction of active ingredients from Magnoliae Officinalis Cortex dregs（MOCD）， and to provide a reference basis for the utilization of resource components in MOCD. MethodLiquid chromatography-mass spectrometry（LC-MS） was used for qualitative analysis of resource components in MOCD with an Agilent C18 reversed-phase column（3.0 mm×100 mm， 2.7 µm） at the flow rate of 0.4 mL·min-1， the mobile phase was water（A）-acetonitrile（B） for gradient elution（0-3 min， 25%-48%B； 3-6 min， 48%-59%B； 6-10 min， 59%-80%B； 10-20 min， 80%-90%B； 20-25 min， 90%B）， electrospray ionization（ESI） was employed with negative ion mode scanning and scanning range of m/z 50-1 200. A high performance liquid chromatography（HPLC）， which refered to the determination in the 2020 edition of Chinese Pharmacopoeia， was used for quantitative analysis of resource components in MOCD. Four kinds of pretreatment agents were used to separate the resource components from MOCD， and the mechanism of different pretreatment agents was investigated by field emission scanning electron microscopy（FESEM）， X-ray powder diffraction（XRD） and Fourier transform infrared spectroscopy（FT-IR）. ResultMagnolol， honokiol and lignocellulose were identified as the main resource components of MOCD by qualitative and quantitative analysis. Under the conditions of 1% NaOH， reaction temperature at 80 ℃ and reaction time of 60 min， the concentration of reducing sugar produced by the enzymatic hydrolysis was 32.18 g·L-1， which was 79.8% higher than that of the untreated MOCD. After adding tween-80， the enzymatic hydrolysis time was reduced to 1/3 of the original time， the concentration of reducing sugar was increased by 102.0%. And the total recovery of magnolol and honokiol in the pretreatment solution was 69.23%. ConclusionMagnolol， honokiol and lignocellulosic components in MOCD are valuable for development and utilization， the combination of alkaline pretreatment and tween-80 can realize the recovery and utilization of these three resource components， which can provide a new idea for comprehensive utilization of resource components in MOCD.

Pyridine pigments from functional Monascus rice / 药学学报

The trace chemical components in functional Monascus rice were studied to explore the potential bioactive substances. MCI column, Sephadex LH-20 gel, and preparative liquid chromatography were used to purified the ethyl acetate extract from functional Monascus rice. Two novel pyridine Monascus pigments were isolated and identified, named monascopyridine G (1) and monascopyridine H (2), respectively based on extensive mass spectrometry (MS), infrared radiation (IR), and nuclear magnetic resonance (NMR) analysis. The molecular docking experiments between compounds 1 and 2 and peroxisome proliferators-activated receptor-gamma (PPARγ) showed that they exhibited obvious binding force with the receptor protein. Besides, the biosynthetic pathways of the two compounds were proposed, which provide a valuable reference for the selective production of these potential bioactive substances.

Development and application of drug-induced liver injury surveillance and assessment system / 中国药房

OBJECTIVE To establish the drug-induced liver injury （DILI） surveillance and assessment system （DILI-SAS）， and to improve the diagnostic efficiency of clinical DILI. METHODS The DILI-SAS was constructed by using natural language processing technology to mine and utilize all inpatient medical record data， and combined with Roussel Uclaf causality assessment method （RUCAM）. The medical records of 19 445 hospitalized patients from August 2022 to January 2023 were detected to verify the performance of the system and manually analyze the basic data of patients with DILI and the distribution of the first suspected drugs. RESULTS The overall accuracy rate of the DILI-SAS system was 91.95%， and the recall rate was 93.20%. Seventy-five DILI cases were detected， and the DILI incidence rate was 385.70/100 000 people. The efficiency of DILI monitoring by human- computer coupling was increased by about 60 times of manual monitoring； males （61.33%） and patients over 60 years old （56.00%） were the most common in the 75 cases of DILI. The clinical type of liver injury was hepatocyte injury （69.33%）， the incubation period was mainly 5-90 days after treatment （62.67%）， and the RUCAM score between 3 and 5 was the most common （66.67%）； pharmacological distribution of the first suspected drugs was mainly dihydropyridines， HMG CoA reductase inhibitors， proton pump inhibitors， etc. The specific drugs were atorvastatin， omeprazole， ceftriaxone， metronidazole and other drugs. CONCLUSIONS The establishment of DILI-SAS can improve the evaluation efficiency on the basis of ensuring the accuracy degree， and provide a solution for the early identification， diagnosis and evaluation of clinical DILI.

Efficacy and tolerability of dolutegravir plus lamivudine as a switch simplified strategy in treatment-experienced human immunodeficiency virus/acquired immunodeficiency syndrome patients / 中华传染病杂志

Objective:To evaluate the efficacy and tolerability of the dual therapy of dolutegravir (DTG) plus lamivudine (3TC) as a switch simplified strategy in treatment-experienced human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients.Methods:Treatment-experienced HIV/AIDS patients who switched to a dual therapy containing DTG (50 mg, once daily) plus 3TC (300 mg, once daily) were included in Beijing You′an Hospital, Capital Medical University from September 2016 to May 2019. HIV RNA, CD4 + T lymphocyte count, blood lipid indexes, renal function indexes were collected when patients changed the treatment regimen (baseline) and after 48 weeks of treatment. Efficacy (HIV RNA<50 copies/mL) and safety of the dual therapy were analyzed. Statistical comparisons were performed using the Wilcoxon matched-pairs signed rank test. Results:The reasons for 33 patients switching the treatment regimen were virologic failure (four cases, 12.1%), simplification of regimen (11 cases, 33.3%), and drug toxicity (18 cases, 54.5%). The patients were treated with anti-retroviral therapy (ART) for 2.13 (1.05, 4.23) years before regimens switching. Twenty-nine (87.9%) patients were virologically suppressed at baseline, and four (12.1%) patients were virological failure. After switching to DTG plus 3TC, all 33 patients showed HIV RNA<50 copies/mL after 48 weeks of treatment. The baseline CD4 + T lymphocyte count was 543 (363, 595)/μL. After switching the treatment regimens for 48 weeks, CD4 + T lymphocyte count was significantly increased to 625 (455, 651)/μL, and the difference was statistically significant ( Z=3.14, P=0.002). Compared with baseline, low-density lipoprotein-cholesterol was increased after 48 weeks of treatment (2.35(1.80, 3.08) mmol/L vs 3.12(2.74, 3.87) mmol/L), while triglyceride (2.21(1.27, 4.37) mmol/L vs 1.61(1.20, 2.22) mmol/L), the ratio of total cholesterol to high-density lipoprotein-cholesterol (5.02 (4.13, 6.40) vs 4.70 (3.55, 5.35)) and estimated glomerular filtration rate (106.4(78.2, 118.2) mL/(min·1.73 m 2) vs 88.6 (75.7, 107.9) mL/(min·1.73 m 2)) were decreased. The differences were all statistically significant ( Z=4.89, 2.37, 2.09 and 2.83, respectively, all P<0.050). No patient discontinued due to adverse events. Conclusions:The use of dual therapy containing DTG and 3TC is effective and well-tolerated in treatment-experienced HIV/AIDS patients under any prior ART without significant adverse events.

Application and Analysis of High-quality Evaluation for Jianwei Xiaoshi Tablets / 中国实验方剂学杂志

Jianwei Xiaoshi tablets， as a common variety of Chinese patent medicine with "one product with many manufacturers"， have many manufacturers and huge market sales. However， the phenomenon about uneven quality and discrepant price is prominent. Based on this， this study was carried out for the quality evaluation of Jianwei Xiaoshi tablets by applying the high-quality evaluation criteria with the quality as core for Chinese patent medicine， which was based on the full production cycle， from the multi-dimension including raw material selection， production process， quality control， post-marketing research and so on. The evaluation results showed that the quality evaluation scores of Jianwei Xiaoshi tablets from different manufacturers varied greatly （ranging from 35 to 66）， indicating that the quality was significantly different. In the actual production， generally inadequate attention was paid to the quality of raw materials， and the quality of raw materials was insufficient with the score ratio of 43%， especially the poor consistency control of them. The role of good manufacturing practice was obvious， and the scores of production process were generally high with the average score ratio of 62%， and the maximum up to 80%. The technological advancement of the manufacturer was outstanding. The score ratio of quality control was only 31% that the internal quality standard of each manufacture almost stayed at the qualified line， which was equal to the national standard， and the consistency of products was insufficient. The post-marketing research was lacking with the score ratio of 37%. Manufacturers with high brand awareness and market share were upper scores， while the others lagged far behind. The results of this evaluation are in line with the overall prediction， which can provide a reference for the high-quality evaluation of Chinese patent medicine， and supply the scientific data for high-quality and high-price application.

Short-term clinical outcomes of outpatient total hip arthroplasty / 中华骨科杂志

Objective:To investigate the safety, economic effect, and short-term clinical efficacy of ambulatory total hip arthroplasty (THA) in the treatment of hip osteopathy within.Methods:This study retrospectively reviewed patients who underwent 48-hour outpatient THA and conventional primary THA from July 2020 to July 2021. Gender, age, body mass index (BMI), clinical diagnosis, place of resident, length of hospital stay, duration of the surgery, hemoglobin, albumin, C-reactive protein (CRP) and D-dimer before and 1 day after surgery, the visual analogue scale (VAS) was obtained postoperative day 2, hip joint modified Harris score before and 1 month after surgery, readmission and reoperation within 1 month after operation as the data of evaluations were extracted and compared in this study.Results:A totally of 150 cases were involved in this study, which including 75 cases with 48-hour outpatient primary THA and 75 cases with conventional primary THA. There was no significant difference between the two groups in terms of age, sex, BMI, education level, preoperative diagnosis, and preoperative Harris score ( P>0.05), but a significant difference was found in term of residence (χ 2=6.29, P=0.043), that the patients in the outpatient group were all from Zhejiang Province and 48% (36/75) of them were from Hangzhou City. While, in the conventional group, 6 patients were from other provinces. The length of stay was 2.13±0.52 days and operation time was 59.73±18.91 minutes in the outpatient group, which were both shorter than those (6.71±1.44 days and 66.91±22.40 min) in the conventional group ( t=25.91, P<0.001 for the length of hospital stay; t=2.12, P=0.036 for operation time). Compared with the conventional group, outpatient group saved the average hospital cost (4.60±0.44 vs. 5.20±0.72 ten thousand yuan, t=6.16, P<0.001). The VAS on the second day after surgery 3.45±0.75 was higher in the outpatient group than in the conventional group (3.45±0.75 vs. 3.16±0.94 points, t=2.09, P=0.039). The modified Harris score was without statistical significance ( t=0.42, P=0.677) 1 month after surgery in both groups. 75 patients in the outpatient group, 7 patients delayed discharge (were not discharge within 48 hours), and the rate of delayed discharge was 9.3%. Reasons for delayed discharge included poor pain control in two cases, one case had postoperative nausea and vomiting, one case had failed to meet rehabilitation standards, hypotension in one case, the intraoperative infection in one case and postoperative fever within 48 hours in one case. Conclusion:Outpatient THA can reduce the length of hospital stay, operative time and total cost of hospitalization. It has similar safety and early clinical efficacy as conventional THA. However, a small proportion of patients would delay discharge.

Effects of astragaloside Ⅳ on inflammatory response and percentage of peripheral blood Th17 cells in mice with ulcerative colitis / 中国中药杂志

This study aimed to investigate the anti-inflammatory effect of astragaloside Ⅳ in mice with ulcerative colitis(UC) and its effect on the percentage of peripheral blood T helper(Th17) cells. Following the establishment of UC mouse model with 2% sodium dextran sulfate(DSS), mice in the positive control group and low-and high-dose astragaloside Ⅳ groups were treated with corresponding drugs by gavage. Disease activity index(DAI) was calculated, and serum interleukin-17(IL-17), tumor necrosis factor-α(TNF-α), and transforming growth factor-β(TGF-β) levels were assayed by ELISA. The pathological changes in colon tissue were observed by HE staining, and Th17/regulatory T cells(Treg) ratio in the peripheral blood was determined by flow cytometry. Western blot was conducted for detecting the relative protein expression levels of forkhead box protein P3(Foxp3) and retinoic acid-related orphan nuclear receptor γT(ROR-γt). The findings demonstrated that in normal mice, the colonic structure was intact. The goblet cells were not reduced and the glands were neatly arranged, with no mucosal erosion, bleeding, or positive cell infiltration. In the model group, the colonic mucosal structure was seriously damaged, manifested as disordered arrangement or missing of glands, vascular dilatation, congestion, and massive inflammatory cell infiltration. The pathological injury of colon tissue was alleviated to varying degrees in drug treatment groups. Compared with the normal group, the model group exhibited elevated percentage of Th17 cells, increased IL-17 and TNF-α content, up-regulated relative ROR-γt protein expression, lowered TGF-β, reduced percentage of Treg cells, and down-regulated relative Foxp3 protein expression. The comparison with the model group showed that DAI score, pathological score, percentage of Th17 cells, IL-17 and TNF-α content, and relative ROR-γt protein expression in the positive control group, low-dose astragaloside Ⅳ group, and high-dose astragaloside Ⅳ group were decreased, while TGF-β content, percentage of Treg cells, and relative Foxp3 protein expression were increased. The DAI score, pathological score, percentage of Th17 cells, IL-17 and TNF-α content, and relative ROR-γt protein expression in the low-dose astragaloside Ⅳ group were higher than those in the positive control group, whereas the content of TGF-β, percentage of Treg cells, and relative Foxp3 protein expression were lower. DAI score, pathological score, percentage of Th17 cells, IL-17 and TNF-α content, relative ROR-γt protein expression in the high-dose astragaloside Ⅳ group declined in contrast to those in the low-dose astragaloside Ⅳ group, while the TGF-β content, percentage of Treg cells, and relative Foxp3 protein expression rose. There was no significant difference between the positive control group and the high-dose astragaloside Ⅳ group. Astragaloside Ⅳ is able to inhibit inflammatory response and diminish the percentage of Th17 cells in mice with UC.

Mid-term results of endovascular intervention for transplant renal artery stenosis / 中华普通外科杂志

Objective:To evaluate the mid-term results of endovascular treatment for transplant renal artery stenosis (TRAS).Methods:The clinical and follow-up data of TRAS patients undergoing endovascular treatment at the First Affiliated Hospital of Zhengzhou University from Jan 2014 to Jan 2021 were retrospectively analyzed.Results:A total of 2 230 patients underwent kidney transplantation, 78 cases(3.6%) developed TRAS, among those 27 patients received endovascular treatment and followed-up from 12 to 80 months(mean 36 months). Thirteen patients (48.1%) underwent renal graft angiography and balloon dilatation, of which 2 patients underwent stent placement, 14 patients (51.9%) underwent renal graft angiography with balloon dilatation and stenting. The serum creatinine 2 weeks postoperatively and 12 months postoperatively were 127.6 μmol/L (47-220 μmol/L) and 103.4 μmol/L (63-166 μmol/L), respectively, significantly lower than the preoperative 217.1 μmol/L (98-541 μmol/L), ( P<0.05). Glomerular filtration rate (GFR) before surgery was 8.3-105.3 ml/min, 2 weeks and 12 months after surgery compared to 24.6-132.2 ml/min and 47.3-113.9 ml/min( P<0.05). The preoperative peak systolic velocity (PSV) of the transplanted renal artery during the systolic phase was 234 cm/s (75-457 cm/s), compared to 129 cm/s (52-290 cm/s) ( P<0.05) 2 weeks and 118 cm/s (57-300 cm/s) 12 months postoperatively ( P<0.05). During the follow-up period, 2 patients (7.4%) died of multiple organ failure. Conclusions:TRAS is the most common vascular complication after kidney transplantation. Endovascular treatment has a high success rate and low complication rate.

A survey of awareness of retinopathy among diabetic patients in communities of Shenzhen / 中华眼底病杂志

Objective:To investigate the awareness of diabetic retinopathy (DR) prevention and treatment knowledge of diabetic patients in the community of Shenzhen, and analyze its influencing factors.Methods:A cluster random sampling method was used to select 904 patients with diabetes diagnosed in 6 community health service centers in 2 administrative districts of Shenzhen and included in this study. Questionnaire survey of patients were performed to understand their knowledge of DR prevention and treatment. The multi-factor logistic regression analysis method was used to analyze the related influencing factors of DR prevention knowledge awareness.Results:Among 904 patients, 144 patients (15.93%, 144/904) knew about DR prevention and treatment knowledge. The highest awareness rate were about "Diabetes can affect vision and even cause blindness" (88.60%, 801/904). The lowest awareness rate (6.20%, 56/904) were about "DR treatment methods". About "diabetes requires regular fundus examinations" and "diabetics", the awareness rate of fundus examination interval were less than 50.00%. The results of multivariate logistic regression analysis showed that gender [odds ratio ( OR)=1.595], education level ( OR=2.963, 3.937), monthly income level ( OR=3.871, 4.675), diabetes course ≥15 years ( OR=1.829), treatment measures ( OR=3.318, 4.512). Whether people had DR ( OR=1.605) were important factors that affected the awareness of DR prevention and treatment knowledge ( P<0.05). Conclusions:The overall awareness of DR prevention and treatment knowledge among diabetic patients in the community of Shenzhen is relatively low. Males, low education and income levels are the main influencing factors.

Oblique branch of anterolateral thigh flap: Understand it and issues to handle / 中华显微外科杂志

Objective:To summarize the oblique branches found in the transfer of anterolateral thigh flap (ALTF) and to handle the issues of oblique branch.Methods:Thirty patients who require surgery of ALTF transfer from May, 2017 to October, 2019 were enrolled. CTA examination was perfected prior surgery and the origin of ALTF vessels was preliminarily determined. During the surgery, Three-longitudinal-and-five-transverse methods were used to locate and design the flap. The ALTF was taken according to the flap design. Attention should be paid to the location of the oblique branch and the separation of the vessels of oblique branch to avoid a damage as much as possible. The vessels of oblique branch should be completely explored and separated. One or 2 vascular pedicles were cut according to whether the oblique branch vessels and the descending branch vessels were joined together during surgery. Clamping tests were carried out on the 2 vascular pedicles to determine an arterial blood supply. Super drainage of vascular pedicle veins according to the situation of blood circulation. After the surgery, routine treatment was carried out. Blood supply, skin temperature, swelling degree, exudation and survival of the flap were closely observed and regular follow-up was carried out.Results:Among the 30 ALTF examined by CTA, 13 patients were identified with oblique branch vessels before operation. During operation, 11 oblique branch vessels (The occurrencce rate was 36.6%)were found to enter the flap, and were completely preserved. Of the 11 identified oblique branch vessels, 8 had 2 vascular pedicles taken and the vascular pedicles were treated by venous super drainage technique. The postoperative blood supply of the flap was good; The skin temperature was closed to surrounding normal skin; Swelling of flap was minor and there was little seepage. The flaps all survived after surgery with stage one healing. Followed-up time was 3-32 (average 16.1) months. The recipient site healing was good, and the function and appearance were satisfactory. The joint movement at the donor site was normal, and there was no obvious loss of local sensation.Conclusion:More than one third of the oblique branches appear in this group. The oblique branch vessels should be preserved as much as possible to avoid issues in relation to the oblique branch. Reasonable handling of oblique branch is the key to the success of the surgery.

Analysis on the diagnosis and treatment of necrotizing fasciitis complicated with sepsis / 中华危重病急救医学

Objective:To recognize the characteristics of necrotizing fasciitis patients complicated with sepsis and summarize the experience the treatment.Methods:A retrospective study was conducted. The clinical data of 57 patients with necrotizing fasciitis complicated with sepsis admitted to Guangdong Provincial People's Hospital from July 2009 to December 2019 was analyzed by collecting such factors as gender, age, complications, infection sites, pathogens, surgery information, treatment options and outcome. The patients were divided into debridement group ( n = 14) and control group ( n = 43) according to whether the debridement was completed within 48 hours of admission, and the mortality during hospitalization between the two groups was compared. A telephone follow-up had been done to record the long-term outcome of these patients. Results:Among 57 patients with necrotizing fasciitis complicated with sepsis, there were 43 males and 14 females with the average age of (57.9±12.1) years old. Most of the underlying diseases were diabetes mellitus (70.17%), other diseases included hypertension (8.77%), tumor chemotherapy (7.02%), liver disease (hepatitis, cirrhosis, 7.02%), coronary artery heart disease (3.51%), systemic lupus erythematosus (3.51%), etc. Most of the infection site was lower limbs (71.93%). There were 78 pathogens cultured in 57 patients, in which 52 were non-drug resistant bacteria (66.67%), and 26 were drug resistant bacteria (33.33%). There were 40 Gram positive (G +) bacteria (51.28%), 29 Gram negative (G -) bacteria (37.18%), 8 fungi (10.26%) and 1 mixed bacteria (1.28%). Finally, of 57 patients, 46 patients were cured, and 11 patients died with hospital mortality of 19.30%. Among 57 patients, the hospital mortality in the debridement group was significantly lower than that in the control group [0% (0/14) vs. 25.58% (11/43), P < 0.05]. Among the 46 cured patients, 11 had accepted amputations, accounting for 23.91%. In December 2020, 43 patients who were cured (3 patients were lost to follow-up) were followed up by telephone. Twenty-three patients were completely self-care, 9 patients were partly self-care, 8 patients were completely unable to take care of themselves, and 3 patients died. Conclusions:Necrotizing fasciitis with sepsis mostly occurs in people with weakened immunity, and has a high mortality and disability rate. Early identification and active surgical debridement may be the key to improve the treatment effect.

Analysis of the epidemiological characteristics of new occupational pneumoconiosis in Jiangxi Province, 2010-2019 / 中国职业医学

OBJECTIVE: To analyze the epidemiological characteristics of new occupational pneumoconiosis(hereinafter referred to as pneumoconiosis) in Jiangxi Province from 2010 to 2019. METHODS: The data of new pneumoconiosis cases in Jiangxi Province from 2010 to 2019 were collected through the Occupational Disease and Occupational Disease Health Information Monitoring Subsystem in the China Disease Prevention and Control Information System, and a retrospective analysis was conducted. RESULTS: From 2010 to 2019, there were 4 450 new cases of pneumoconiosis in Jiangxi Province. Among these cases, the main disease types were coal workers′ pneumoconiosis and silicosis, accounting for 98.5%. The number of new cases of pneumoconiosis showed a decreasing trend with the increase of years for the last ten years(P<0.05). The median age and the 0 th-100 th percentile [M(P_0-P_(100))] of new-onset pneumoconiosis diagnosis was 56.6(34.0-97.0) years old. The service length M(P_0-P_(100)) with dust-exposure was 12.0(1.0-48.0) years. The main industry of the new pneumoconiosis cases was concentrated in the coal mining and washing industry(63.4%). The distribution of economic types of enterprises with new pneumoconiosis cases was mainly state-owned enterprises(70.0%). The enterprise scale was medium-sized and small enterprises(65.9% in total). The types of work were mainly coal blenders, rock drillers, and coal miners, accounting for 56.5%. CONCLUSION: The incidence of occupational pneumoconiosis in Jiangxi Province is not optimistic. It is necessary to strengthen the prevention and control of occupational diseases on workers exposed to dust in key industries, enterprises and types of work.

Grade Evaluation of Salviae Miltiorrhizae Radix et Rhizoma Decoction Pieces Based on Relative Quality Constant / 中国实验方剂学杂志

Objective:To establish the grade evaluation standard of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces combining traditional character evaluation and modern intrinsic quality analysis. Method:The appearance character parameters （thickness and weight） and contents of internal index components （tanshinones and salvianolic acid B） of 18 batches of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces were determined， and the relative quality constant was calculated. The maximum value of the percentage quality constants of the tested samples was assumed to be 100%， the value ≥80% was classified as the first-class， ≥50% and <80% as the second-class， <50% as the third-class. Result:The relative quality constants of 18 batches of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces ranged from 349 to 884. According to the percentage quality constant， 18 batches of samples were successfully divided into three grades. The relative quality constant of the first-class product was ≥707， including samples ds5， ds8 and ds14， accounting for about 17% of the total number of samples. The relative quality constant of the second-class product was ≥442 and <707， accounting for about 61% of the total number of samples. the other samples were of the third-class， and their relative quality constants were all <442. Conclusion:The method of relative quality constant overcomes the one-sidedness of the single method in the grade evaluation of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces， and the evaluation results can objectively， reasonably and scientifically classify the grade of the decoction pieces， which can provide reference for the establishment of the grade standard of other decoction pieces.

Reuse of Resource Components in Residue of Shaoyao Gancaotang / 中国实验方剂学杂志

Objective:Aiming at the residue of Shaoyao Gancaotang， the extraction， qualitative and quantitative study of the small molecule resource components were carried out to clarify the residual small molecule chemical components in the residue and explore the ways of its resource utilization. Method:The ultra-performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry （UPLC-QTOF-MS/MS） was used to qualitatively identify the residual small molecule substances in the dregs of Shaoyao Gancaotang. Agilent C₁₈ reversed-phase chromatographic column （3.0 mm×100 mm， 2.7 µm） was used at the flow rate of 0.4 mL·min^-1， the injection volume was 5 µL， and the mobile phase was gradient eluted with 0.05% formic acid aqueous solution （A）-acetonitrile （B） （0-1 min， 14%-17.5%B； 1-3 min， 17.5%-19%B； 3-4 min， 19%-20%B； 4-5 min， 20%B； 5-6 min， 20%-21%B； 6-9 min， 21%B； 9-22 min， 21%-36%B； 22-23 min， 36%B； 23-32 min， 36%-43%B）， electrospray ionization （ESI） was employed with negative ion mode scanning and scanning range of <italic>m</italic>/<italic>z</italic> 50-1 200. A high performance liquid chromatography （HPLC） was established for the quantitative analysis of its main components with Agilent C₁₈ reversed-phase chromatographic column （4.6 mm×150 mm， 5 µm）， the detection wavelength was set at 235 nm， the flow rate was 0.8 mL·min^-1， and the injection volume was 5 µL. Mobile phase was 0.05% phosphoric acid （A）-acetonitrile （B） for gradient elution （0-1 min， 14%-19%B； 1-4 min， 19%B； 4-18 min， 19%-50%B）. The content changes of main components in the residue of Shaoyao Gancaotang were compared before and after two different techniques of organic solvent extraction and enzymatic extraction. Result:A total of 16 chemical components in the residue of Shaoyao Gancaotang were qualitatively analyzed， and quantitative analysis found that there were many chemical components in the residue， among which the residues of 6 index components such as paeoniflorin and liquiritin reached more than 70% in the original decoction piece. After enzymolysis by cellulase， liquiritin in the residue could be converted into liquiritigenin. The content of crude polysaccharide in enzymatic extract of the residue was 6 times higher than that in the blank group， and the content was up to 12%. Conclusion:There are still many small molecule resource components in the residue of Shaoyao Gancaotang， which has great development potential. Organic solvents can be used to re-extract the target components in the residue， and liquiritin can be converted into liquiritigenin by biological fermentation technology， and the crude polysaccharide from the residue can be extracted by enzymatic method to develop animal feed. This study can provide reference basis and approach for reusing the residues of Shaoyao Gancaotang preparations and dispensing granules， so as to realize the high-value utilization of Shaoyao Gancaotang.