Probing the Impact of Whole Intestinal Microbiota Transplantation from Alzheimer's Disease Model Mice on the Ileal Microenvironment Based on the “Interior-Exterior Relationship Exists Between Heart and Small Intestine” / 中山大学学报(医学科学版)

ObjectiveTo investigate whether the whole intestinal microbiota transplantation in Alzheimer's disease （AD） model mice has more significant effects on ileum intestinal microenvironment in normal mice under the guidance of the theory of traditional Chinese medicine that "interior-exterior relationship exists between the heart and small intestine". MethodsThe whole intestinal microbiota of fourteen 6-month-old specific pathogen free male APP/PS1 double-transgenic AD model mice was transplanted into the gut of six normal C57BL/6J mice of the same age and background treated with mixed antibiotics for 14 days. Then， after 14 days of normal rearing， the mice were sacrificed. Next， the pathological changes in the ileum and colon were observed， and the composition and diversity of the ileal and colonic microbiota was analyzed by sequencing. ResultsAfter the whole intestinal microbiota of AD mice was transplanted into normal mice， pathological analysis showed that only the ileum tissue had mucosal damage and crypt gland epithelial cell degeneration， necrosis， and shedding. Moreover， the microbiota analysis found that only the number of genera （P<0.01）， Chao1 index （P<0.01） and Simpson index of ileal microbiota in normal mice decreased （P<0.01）， and the composition of intestinal microbiota was quite similar to that of AD model mice. ConclusionUnder the effect of whole gut microbiota transplantation in AD mice， the diversity and composition of ileal microbiota change more than that of colonic microbiota in normal mice， and at the same time， it results in pathological damage to the ileal mucosa， indicating that the ileal microenvironment may be more closely related to the occurrence and development of AD， which is highly consistent with the traditional Chinese medicine theory of "interior-exterior relationship between heart and small intestine".

Role of TGF-β/Smad signaling pathway in diabetic kidney disease and research progress of traditional Chinese medicine intervention / 中国中药杂志

Diabetic kidney disease is an important microvascular complication of diabetes and the leading cause of end-stage renal disease. Its pathological characteristics mainly include epithelial mesenchymal transition(EMT) in glomerulus, podocyte apoptosis and autophagy, and damage of glomerular filtration barrier. Transforming growth factor-β(TGF-β)/Smad signaling pathway is specifically regulated by a variety of mechanisms, and is a classic pathway involved in physiological activities such as apoptosis, proliferation and differentiation. At present, many studies have found that TGF-β/Smad signaling pathway plays a key role in the pathogenesis of diabetic kidney disease. Traditional Chinese medicine has significant advantages in the treatment of diabetic kidney disease for its multi-component, multi-target and multi-pathway characteristics, and some traditional Chinese medicine extracts, traditional Chinese medicines and traditional Chinese medicine compound prescription improve the renal injury of diabetic kidney disease by regulating TGF-β/Smad signaling pathway. This study clarified the mechanism of TGF-β/Smad signaling pathway in diabetic kidney disease by expounding the relationship between the key targets of the pathway and diabetic kidney disease, and summarized the research progress of traditional Chinese medicine in the treatment of diabetic kidney disease by interfering with TGF-β/Smad signaling pathway in recent years, to provide reference for drug research and clinical treatment of diabetic kidney disease in the future.

Update and interpretation of Elsevier clinical pathway for gastric, gastroesophageal junction and esophageal cancer ( Chinese edition, 2022) / 中华消化杂志

The standardized treatment of malignant tumor has always been the direction of continuous improvement of major medical institutions. In recent years, the basic research, prevention, screening and diagnosis and treatment level of gastric, gastroesophageal junction and esophageal cancer have been greatly improved, resulting in a significant improvement in the 5 years′ survival rate of patients, but there are still great differences in the diagnosis and treatment level among different regions. Chinese gastric cancer, gastroesophageal junction cancer and esophageal cancer differ greatly from European and American countries in etiology, pathological types, high incidence sites, etc. Therefore, the relevant guidelines of European and American countries cannot fully meet Chinese clinical practice. In 2021, Elsevier Publishing Group launched the Chinese edition of Elsevier clinical pathway for gastric, gastroesophageal junction and esophageal cancer, and the first update edition was made in 2022, which aims to promote the quality control of tumor diagnosis and treatment, standardize tumor diagnosis and treatment behaviors, promote the homogenization and standardization of tumor diagnosis and treatment, and ultimately improve the survival rate and quality of life of patients with malignant tumor. This pathway refers to the National Comprehensive Cancer Network clinical practice guidelines, the Chinese Society of Clinical Oncology guidelines, combines evidence-based medicine and clinical experience, and follows the scientific, universal, standardized and operable principles. It has been promoted and applied in clinical practice, and is constantly updated according to the latest research results.

A Bibliometric Analysis and Visualization of Current Research Trends in Chinese Medicine for Osteosarcoma / 中国结合医学杂志

BACKGROUND@#To illustrate the research framework, overall knowledge structure, and development trends of Chinese medicine (CM) treatment for osteosarcoma (OS) by using a bibliometric analysis and newly developed visualization tools.@*METHODS@#Research datasets were acquired from the Web of Science (WOS) database from January 1, 1980 to September 30, 2019. VOS viewer and Citespace software was used to analyze the data and generate visualization knowledge maps. Annual trends of publications, distribution of institutes, distribution of journals, citation and H-index status, co-authorship status, research hotspots and co-citation status were analyzed.@*RESULTS@#A total of 223 publications in the WOS database met the requirement. The number of published articles showed a rise but the citation frequency and the H-index of China were relatively low. The cooperation between the countries, institutes and authors were relatively weak. Most publications were basic researches. Most of the previous researches focused on basic mechanisms of CM in treating OS, and therapy and improvement of dosage form may become a frontier in this research field.@*CONCLUSIONS@#Compared with other fields, the field of CM treatment for osteosarcome is still in infancy. The distribution of researches is imbalanced and cooperation between countries, institutions and authors remains to be strengthened. Furthermore, basic research occupies an absolute dominant position, and the exploration of the molecular mechanism of CM in preventing and treating OS may become a key point in the future.

Correlation analysis of cervical spine dysfunction, pain and muscle strength in office workers / 中华劳动卫生职业病杂志

Objective: To expore the correlation between neck disability, neck pain and muscle strength in cervical pondylosis of office worker, and to provide scientific basis for the prevention and treatment of cervical spondylosis. Methods: In April 2021 ,234 patients with cervical spondylotic myelopathy treated in the Subsidiary Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from April 2015 to April 2017 were selected, the correlation between Neck Disability Index (NDI) score, neck pain and muscle strength was analyzed using the Spearman rank correlation method. Mann-Whitney U test was used to compare the difference of maximum muscle strength of isometric contraction. Results: NDI score was negatively correlated with neck flexion, extension, and muscle strength in the left and right flexion directions (r(s)=-0.164, -0.169, -0.222, -0.176, P=0.012, 0.010, 0.001 , 0.007). In mild and moderate functional disorder patients, the muscle strength in flexion, extension and left and right flexion direction was greater, the difference was statistically significant (P <0.01). Conclusion: There is a negative correlation between cervical functional disorder and cervical muscle strength in office workers, suggesting that strengthening cervical muscle strength may be a way to improve cervical spine function.

Preliminary exploration of medical service price reform based on choice behavior motivation / 中华医院管理杂志

Medical service pricing system is the basic system of health economics, which has a profound impact on physicians′ medical behavior and the running mode of hospital. Rui′an City, Wenzhou City, Zhejiang Province, freed up the cost space of drug and consumables based on the reasonable diagnosis and treatment behavior of doctors and selection of drug and consumables in the hospital procurement link. 68% of the free space was used to improve the price of medical services. 248 medical service items with obvious cost inversion were selected, such as nursing, traditional Chinese medicine, diagnosis, etc., and the price adjustment range was determined according to the agreed free space limit. Meanwhile, the credit mechanism of Alipay was applied to synchronously implement " vacating space and adjusting structure" , so as to solve the game problem between medical treatment and medical insurance, broaden the path of the " translation compensation method" of medical service price reform, and produce policy superposition and linkage effect with the reform of medical insurance payment mode.

Effect of Usnea diffracta Against Atherosclerosis in Rats and on Microbial Flora of Ileum： An Investigation Based on Interior-exterior Relationship Between Heart and Small Intestine / 中国实验方剂学杂志

Objective:To explore the correlation between the efficacy of <italic>Usnea diffracta</italic> in treating atherosclerosis （AS） and the altered microbial flora in rat ileum based on the interior-exterior relationship between heart and small intestine in traditional Chinese medicine （TCM）. Method:Forty-eight SD rats were randomized into a normal group （<italic>n</italic>=8） and a modeling group （<italic>n</italic>=40）. The AS model was established with high-fat diet combined with intraperitoneal injection of vitamin D₃. The successfully modeled rats were further randomly divided into the model group， positive control （simvastatin， 4 mg·kg^-1） group， and low- （0.7 g·kg^-1）， medium- （1.4 g·kg^-1）， and high-dose （2.8 g·kg^-1） <italic>U. diffracta</italic> ethanol extract groups， with eight rats in each group. After four weeks of intervention， the blood， aorta， ileum， and ileum content of rats in each group were collected. The levels of serum lipopolysaccharide （LPS）， tumor necrosis factor-<italic>α </italic>（TNF-<italic>α</italic>） and interleukin 6 （IL-6） were measured by enzyme-linked immunosorbent assay （ELISA）， and the pathological changes in rat thoracic aorta was detected by hematoxylin-eosin （HE） staining. Western blot was conducted to determine the protein expression levels of tight junction protein zonula occluden （ZO-1） and Occludin in rat ileum， and the high-throughput 16S rRNA sequencing technology was employed to detect changes in microbial diversity and abundance in rat ileum of each group. Result:Compared with the normal group， the model group exhibited obvious aortic plaque deposition， increased LPS， TNF-<italic>α</italic>， and IL-6 levels （<italic>P</italic><0.01）， but decreased ZO-1 and Occludin protein expression （<italic>P</italic><0.01）. The comparison with the model group revealed that <italic>U. diffracta</italic> significantly ameliorated the aortic plaque deposition of model rats， lowered serum LPS， TNF-<italic>α</italic>， and IL-6 levels （<italic>P</italic><0.05， <italic>P</italic><0.01）， and up-regulated ZO-1 and Occludin protein expression （<italic>P</italic><0.05， <italic>P</italic><0.01）. The abundance of Proteobacteria and Bacteroidetes in the model group changed significantly in contrast to that in the normal group， and the Bacteroidetes/Firmicutes（B/F） value declined （<italic>P</italic><0.05）. Alpha and Beta diversity analysis indicated higher total number of intestinal flora species in the model group， but lower richness and uneven distribution （<italic>P</italic><0.05， <italic>P</italic><0.01）， with a large number of pathogenic bacteria enriched. The ethanol extract of <italic>U. diffracta</italic> significantly increased the B/F value， corrected the structural disorder of microbial flora in ileum， reduced pathogenic bacteria， and increased the relative abundance of probiotics. Conclusion:<italic>U. diffracta</italic> exerts the therapeutic effect against AS possibly by improving the intestinal microbial communities， strengthening the intestinal mucosal barrier function， and reducing the serum LPS and inflammatory factors.

Efficacy of Spleen-invigorating Chinese Medicinals in Repairing Intestinal Mucosal Barrier Injury： A Review / 中国实验方剂学杂志

As the first line of defense between the intestinal environment and the outside world， the intestinal mucosal barrier is essential for maintaining the intestinal homeostasis. The intestinal mucosal barrier injury will change the intestinal permeability and allow bacterial translocation and the entry of endotoxins into blood， thus triggering a series of inflammatory responses， followed by the injury of related tissues and the aggravation of primary diseases. The spleen， the acquired foundation， is responsible for maintaining the internal and external balance of the body and resisting external evils. Its physiological function is similar to that of the intestinal mucosal barrier. Spleen deficiency easily leads to intestinal mucosal barrier dysfunction. Therefore， replenishing Qi， invigorating spleen， and restoring the efficacy of spleen and stomach qi in defensing and governing transportation and transformation are the keys to prevent and treat intestinal mucosal barrier injury. In recent years， studies have shown that the spleen-invigorating Chinese medicinals repair the intestinal mucosal injury by promoting the expression of intestinal epithelial tight junction proteins， regulating the intestinal immune function， microbial flora， and metabolites， and supplementing the intestinal nutrition， enabling them to gradually become a research hotspot. After reviewing the relevant articles published in China and abroad， this paper expounded the common syndrome types of traditional Chinese medicine （TCM）， the changes in intestinal mucosal barrier induced by spleen deficiency， the repairing effects of spleen-invigorating Chinese medicinals on intestinal mucosal barrier injury， in order to provide some clues for the research on the treatment of intestinal mucosal barrier dysfunction-related diseases with spleen-invigorating Chinese medicinals.

Randomized controlled trials of acupuncture and moxibustion in China in past 45-year (1975-2019): hotspots and trends / 中国针灸

By searching the randomized controlled trials (RCTs) of acupuncture and moxibustion from CNKI since its inception date to december 31 of 2019, the development status and hot trend of RCTs of acupuncture and moxibustion in China were summarized. The CiteSpace and VOSviewer software were used to perform keyword co-occurrence analysis, clustering analysis, time-zone analysis and citation-burst analysis, and visual map was drawn. As a result, a total of 60 995 articles were included, which were published in 1027 academic journals with 1787 keywords. The publication date was from 1975 to 2019. During the past 45 years, the publications of RCTs on acupuncture and moxibustion had shown an overall growth trend with characteristics of the times. The RCTs of manual acupuncture ranked the top, and its proportion of publications every 5 years was stable in the past 30 years. Since 1994, the hot words such as electroacupuncture, warming needling, auricular point sticking and various acupoint therapies had emerged; meanwhile, the spectrum of diseases had broadened, and an evolutionary trend corresponding to therapies and disease systems had been formed. In recent decade, the RCTs using moxibustion therapy have increased significantly, and the hot words such as "sub-health" "winter diseases being treated in summer" and "acupoint application/ moxibustion during the dog days" had indicated that acupuncture clinical research was further inclined to the field of chronic disease prevention and health services, which was in line with social development and the needs of the times.

Clinical observation of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia / 中国骨伤

OBJECTIVE@#To explore clinical effect of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia.@*METHODS@#From January 2018 to December 2019, 168 patients who met inclusion criteria and were underwent selective spine surgery, were double-blind divided into two groups according to central random system, 84 patients in each group. In control group, there were 39 males and 45 females aged from 30 to 65 years old with an average of (53.83±9.17) years old, 37 patients were classified to typeⅠand 47 patients were typeⅡ according to American Society of Anesthesiologists (ASA) grading. In experiment group, there were 39 males and 45 females aged from 30 to 65 years old with an average of (54.08±9.00) years old; 32 patients were classified to typeⅠand 52 patients were typeⅡ according to ASA grading. Both of two groups were obtained acupoint application before anesthesia induction, and acupoint application were put on @*RESULTS@#There were no statistical differences in incidence of nausea vomiting, VAS of narusea degree at 24 h after operation (@*CONCLUSION@#The curative effect of acupoint application of traditional Chinese medicine on the prevention and treatment of postoperative nausea and vomiting is not obvious.

Main components in butyl alcohol extract of Baitouweng Decoction inhibited neutrophil chemotaxis / 中国中药杂志

The present study aims to investigate the effects of the main components(aesculin, berberine hydrochloride, and anemoside B4) in the butyl alcohol extract of Baitouweng Decoction(BAEB) on the chemotaxis of neutrophils induced by dimethyl sulfoxide(DMSO). HL60 cells were cultivated in RPMI-1640 complete medium, and transferred into a 6-well plate(2 × 10~5 per mL) with 4 mL in each well, followed by incubation with DMSO at 1.3% for five days. The morphologic changes of cells were observed under an inverted microscope. The CD11 b expression after DMSO induction was analyzed by flow cytometry. The effects of aesculin, berberine hydrochloride, and anemoside B4 on the cell proliferation and migration were detected by CCK8 assay and Transwell assay, respectively. The effects of the main components on the production and polarization of F-actin protein were also examined by flow cytometry and laser confocal microscopy. PI3 K/Akt signaling pathway was checked by Western blot. As revealed by the results, neutrophil-like HL60 cells were observed after DMSO induction. The CD11 b expression in these cells increased significantly as indicated by the flow cytometry. Additionally, 100 μg·mL~(-1) aesculin, 8 μg·mL~(-1) berberine hydrochloride, and 80 μg·mL~(-1) anemoside B4 were potent in inhibiting the migration of neutrophils and reducing F-actin expression. Berberine hydrochloride was verified to be capable of diminishing phosphorylated PI3 K/Akt protein expression. The findings indicate that aesculin, anemoside B4, and especially berberine hydrochloride in the BAEB can inhibit the chemotaxis of neutrophils, which is possibly achieved by the inhibition of F-actin and PI3 K/Akt signaling pathway.

Research Progress of the Effects of Vitamin D Supplementation on Glycemic Control and Adverse Maternal-neonatal Outcomes in Gestational Diabetes Mellitus Patients / 中国医学科学院学报

Gestational diabetes mellitus(GDM)can cause blood glucose disorders in pregnant women and result in adverse maternal-neonatal outcomes.Vitamin D(VD)can improve glucose tolerance and insulin sensitivity,and thus theoretically,VD supplementation during pregnancy could improve glycemic control as well as maternal-neonatal outcomes in GDM patients.Although studies have shown that VD deficiency is associated with poor maternal-neonatal outcomes in GDM patients,no solid conclusion has been drawn with regard to the effects of VD supplementation on these patients.Therefore,here we summarized the research progress of the effects of VD supplementation on glycemic control and adverse maternal-neonatal outcomes in GDM patients,in an effort to guide the clinical VD supplementation during pregnancy.

Systematic Review of Drug-induced Acute Kidney Injury in Chinese Population / 中国药房

OBJECTIVE：To study clinical situation and influential factors for prognosis of drug-i nduced acute kidney injury （DIAKI）in Chinese population ，and to provide reference for early detection ，early intervention and prognosis improvement of DIAKI. METHODS ：Retrieved from PubMed ，Embase，Cochrane Library ，CNKI，Wanfang database and VIP ，clinical studies related to DIAKI were collected during the inception to Apr. 16th，2020. After the data extraction and quality evaluation of included studies，the results were analyzed descriptively ，and Meta-analysis was carried out by Rev Man 5.3 software. RESULTS ：A total of 29 studies were included ，including 1 870 patients. The results showed that DIAKI accounted for 32.2％（877/2 721）of the patients developed AKI in the same period. Antibacterial drugs were the main cause of DIAKI ，accounting for 47.5％（773/1 629）. The top five drugs by case number were classified as aminoglycoside antibiotics ，diuretics or dehydrating agents ，cephalosporin antibiotics，non-steroidal anti-inflammatory drugs and traditional Chinese medicine. The pathological type of DIAKI was mainly acute interstitial nephritis ，accounting for 51.9％（70/135）. The mortality of DIAKI patients was 14.4％（240/1 677）. A total of 70.4％（1 176/1 670）of patients had renal recovery. Compared with conservative treatment ，the mortality of patients receiving dialysis treatment was significantly lower [OR ＝0.30，95％CI（0.10，0.91），P＝0.003]. Compared with patients without anemia ， patients with anemia had a significantly delayed renal recovery [OR ＝0.25，95％CI（0.09，0.65），P＝0.004]. Lower levels of retinol binding protein was significantly related to rapid renal recovery [MD ＝－15.84，95％CI（－22.34，－9.34），P＜0.01]. CONCLUSIONS：Clinicians need to continuously strengthen antibiotic management and use drugs that induce AKI with caution. For patients with DIAKI ，receiving dialysis treatment as soon as possible may help reduce mortality. Timely correction of the basic anemia status of patients with DIAKI will help patients withrapid renal recovery ，and lower retinol binding protein levels may be a potential biomarker for predicting patients ’rapidrenal recovery.

Research Progress of Butyrate-producing Bacteria in Regulating Intestinal Microecology and Interventional Effect of Chinese Herbal Medicine / 中国实验方剂学杂志

Butyrate-producing bacteria are specific intestinal bacteria with butyrate as the main metabolite, and most of them are Firmicutes.Butyrate-producing bacteria can synthesize butyrate with non-digestible carbohydrates in the diet, and then regulate intestinal microecology and microenvironment, thereby supplying energy to intestinal epithelial cells, affecting intestinal mucosal barrier, adjusting intestinal flora structure and regulating host immunity, so as to alleviate obesity, hypertension and other diseases.Therefore, the targeted regulation of butyrate-producing bacteria and butyrate has become a potential vital method for the prevention and treatment of many diseases.After oral administration, Chinese herbal medicine (CHM) enters the body, and first contacts gastrointestinal tract, so the interaction between CHM and microbiota existing in the intestine is an inevitable important process.It has been confirmed that CHM could regulate intestinal flora; and due to its complex composition and numerous components, CHM can exert interventional effects at multiple levels, in multiple pathways and on multiple targets.Its effect on the butyrate-producing bacteria is as follows.In the intestinal tract, CHM can play a " prebiotic" role, and enrich the beneficial butyrate-producing bacteria, and polysaccharides in CHM can be used as a fermentation substrate to promote the synthesis of butyrate, so as to achieve the effective regulation of butyrate-producing bacteria and butyrate.Based on that, this paper explored the relationship among butyrate-producing bacteria, butyrate and intestinal microecology, and reviewed relevant researches about the intervention of CHM on butyrate-producing bacteria to regulate intestinal microecology in recent years, in order to provide new research ideas for the application of CHM to prevent and treat diseases, as well as drug development.

Potential risk factors for mild cognitive impairment in the elderly population in communities of Shanghai / 公共卫生与预防医学

Objective To investigate the potential risk factors for mild cognitive impairment (MCI) in the elderly population in the community, and to provide a basis for the primary prevention of MCI. Methods A cross-sectional study of elderly population in communities of Shanghai, China was conducted. A total of 368 subjects including both males and females, aged 65-80 years old, were selected to complete the mini-mental state examination (MMSE), basic information questionnaires, and physical examinations. Logistic regression analysis was used to analyze the potential risk factors of MCI. Results Of the 368 subjects participating in the study, 53 were found to have MCI and the prevalence rate was 14.4%. Univariate analysis found that older age, low education, no folic acid supplementation, stroke, osteoporosis and hyperlipidemia were risk factors of MCI. Multiple logistic regression analysis showed that advanced age [OR=1.146 (95%CI: 1.052-1.249)] and osteoporosis [OR=2.371 (95%CI: 1.042-5.396)] were the independent risk factors for MCI, while higher education [OR=0.073 (95%CI: 0.011-0.478)] was a protective factor. Age influenced all the aspects of MMSE scores (all P values <0.05). In addition, the analysis of the results suggested that subjects with regular folic acid supplementation got higher MMSE scores, especially in the aspect of language and praxis (P=0.002). On the contrary, patients with osteoporosis had lower attention and computing power scores (P=0.022). Conclusion The prevalence of MCI increased with age. Low education and osteoporosis may be the independent risk factors for MCI in the elderly population. Although no association was observed between folic acid supplementation and MCI, folic acid supplementation could improve the performance of language and praxis.

Correlation study between accumulation of triterpenoids and expression of relative genes in Alisma orientale / 中国中药杂志

To research the correlation between accumulation of triterpenoids and expression of key enzymes genes in triterpenoid biosynthesis of Alisma orientale,the study utilized UPLC-MS/MS method to detect eight triterpenoids content in the tuber of A. orientale from different growth stages,including alisol A,alisol A 24 acetate,alisol B,alisol B 23 acetate,alisol C 23 acetate,alisol F,alisol F 24 acetate and alisol G,and then the Real time quantitative PCR was used to analyze the expression of key enzymes genes HMGR and FPPS in triterpenoid biosynthesis. Correlation analysis showed that there was a significant positive relation between the total growth of these eight triterpenoids and the average relative expression of HMGR and FPPS(HMGR: r = 0. 998,P<0. 01; FPPS: r = 0. 957,P<0. 05),respectively. Therefore,the study preliminarily determined that HMGR and FPPS genes could regulate the biosynthesis of triterpenoids in A. orientale,which laid a foundation for further research on the biosynthesis and regulation mechanism of triterpenoids in A. orientale.

Pilot technological process evaluation of Compound Banlangen Liyan Granules / 中草药

Objective: To evaluate the pilot technological process of Compound Banlangen Liyan Granules (CBLG). Methods: According to the indexes of six effective ingredients loss amount, accumulated loss rate, and HPLC characteristic spectrum similarity, the process quality of four key processes was evaluated and compared, such as microfiltration of ceramic membrane, vacuum concentration of extract, vacuum drying of concrete, and atmospheric drying of granules. Results: It was found that the total loss rates of glycyrrhizic acid, harpagoside, (R,S)-epigoitrin, liquiritin in two batches were 50.06%—66.99%, and angoroside C, adenosine were 35.49%—41.90%. The total content of the six effective ingredients of each material within the same batch of the two pilot batches from high to low were as follows: extract solution before membrane filtration > extract solution after membrane filtration > concentrate extract solution > dried concrete powder > granules of finished product. The comparison among four key processes loss rates was as follows: vacuum drying of concrete > ceramic membrane microfiltration > vacuum concentration of extract, atmospheric drying of granules. Loss amount of concrete vacuum drying process of the two pilot batches were 0.545 9 and 0.737 5 mg/g, and the process was the major loss process. The total loss rates of the two pilot batches were 48.15%, 50.85%, respectively. The HPLC characteristic spectrum similarity of each material within the same batch of the two pilot batches decreased from 0.998 to 0.818 with increasing process. The HPLC characteristic between the two batches of finished products was good (the similarity was 0.999). Conclusion: The consistency of the finished product quality between two batches was good. The study provided a basis for pilot production process control of CBLG. In the modernization and standardization study of traditional Chinese medicine preparation process, mild process of low temperature and short time heating should be applied as far as possible. It can reduce the effective components loss of original extract (decoction of herbal medicine) in the preparation process and maintain the quality and efficacy consistency of traditional Chinese medicine preparation and original extract (decoction of herbal medicine).

Clinical effect of pidotimod oral liquid as adjuvant therapy for infectious mononucleosis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical effect of pidotimod oral liquid as adjuvant therapy for infectious mononucleosis and its effect on T lymphocyte subsets.</p><p><b>METHODS</b>A total of 76 children with infectious mononucleosis, who were admitted to the hospital between July 2016 and June 2017, were enrolled and randomly divided into two groups: conventional treatment and pidotimod treatment (n=38 each). The children in the conventional treatment group were given antiviral therapy with ganciclovir for injection and symptomatic treatment. Those in the pidotimod treatment group were given pidotimod oral liquid in addition to the treatment in the conventional treatment group. The course of treatment was two weeks for both groups. The two groups were compared in terms of the recovery of clinical indices and the changes in peripheral blood T lymphocyte subsets.</p><p><b>RESULTS</b>Compared with the conventional treatment group, the pidotimod treatment group had significantly shorter fever clearance time, time to the disappearance of isthmopyra, time to the relief of lymph node enlargement, time to the relief of hepatosplenomegaly, and length of hospital stay (P<0.05). After treatment, the pidotimod treatment group had significant reductions in the percentages of CD3 and CD8 T cells and had significantly lower percentages of CD3 and CD8 T cells than the conventional treatment group (P<0.001). The pidotimod treatment group had significant increases in the percentage of CD4 T cells and CD4/CD8 ratio after treatment, which was significantly higher than those in the conventional treatment group (P<0.001). The conventional treatment group had no significant changes in T lymphocyte subsets after treatment (P>0.05).</p><p><b>CONCLUSIONS</b>Pidotimod oral liquid has a good clinical effect as the adjuvant therapy for infectious mononucleosis and can improve cellular immune function, so it holds promise for clinical application.</p>

Randomized double-blind clinical trial of Moluodan () for the treatment of chronic atrophic gastritis with dysplasia / 中国结合医学杂志

<p><b>OBJECTIVE</b>To assess the efficacy and safety of Moluodan () in treating dysplasia in chronic atrophic gastritis (CAG) patients.</p><p><b>METHODS</b>This was a multi-centered, double-blind, randomized controlled trial. The total of 196 subjects were assigned to receive either Moluodan or folic acid in a 2:1 ratio by blocked randomization. Mucosa marking targeting biopsy (MTB) was used to insure the accuracy and consistency between baseline and after 6-month treatment. Primary outcomes were histological score, response rate of pathological lesions and dysplasia disappearance rate. Secondary endpoints included gastroscopic findings, clinical symptom and patient reported outcome (PRO) instrument.</p><p><b>RESULTS</b>Dysplasia score decreased in Moluodan group (P =0.002), significance was found between groups (P =0.045). Dysplasia disappearance rates were 24.6% and 15.2% in Moluodan and folic acid groups respectively, no significant differences were found (P =0.127). The response rate of atrophy and intestinal metaplasia were 34.6% and 23.0% in Moluodan group, 24.3% and 13.6% in folic acid group. Moluodan could improve erythema (P =0.044), and bile reflux (P =0.059), no significance between groups. Moluodan was better than folic acid in improving epigastric pain, epigastric suffocation, belching and decreased appetite (P <0.05), with symptom disappearance rates of 37% to 83%.</p><p><b>CONCLUSIONS</b>Moluodan improved dysplasia score in histopathology, and erythema and bile reflux score in endoscopy, and superior to folic acid in improving epigastric pain, epigastric suffocation, belching and decreased appetite. [ChiCTR-TRC-00000169].</p>

Preliminary studies on critical control point of traceability system in wolfberry / 中国中药杂志

As a traditional Chinese medicine, wolfberry (Lycium barbarum) has a long cultivation history and a good industrial development foundation. With the development of wolfberry production, the expansion of cultivation area and the increased attention of governments and consumers on food safety, the quality and safety requirement of wolfberry is higher demanded. The quality tracing and traceability system of production entire processes is the important technology tools to protect the wolfberry safety, and to maintain sustained and healthy development of the wolfberry industry. Thus, this article analyzed the wolfberry quality management from the actual situation, the safety hazard sources were discussed according to the HACCP (hazard analysis and critical control point) and GAP (good agricultural practice for Chinese crude drugs), and to provide a reference for the traceability system of wolfberry.