[Materia medica illustrations related to the regional names in Zhejiang province in Ben Cao Tu Jing].

Ben Cao Tu Jing had 38 materia medica illustrations related to the regional names in Zhejiang province. It was found that 30 of them were identified as being named after regional names in Zhejiang province, involving 20 families and 29 genera. One of the 38 materia medica illustrations was mineral medicine and seven of them were unverified. The twenty-five of these materia medica illustrations with regional names were found to be consistent with their names used today. Five of them came from similar names in Zhejiang province in the Northern Song Dynasty, another five of the 25 names were known with the names but not entity for the lack of full descriptions and drawings. It was found that the drawing and the text of "Ming Zhou Huang Yao" and "Qin Zhou Hong Yao" in Ben Cao Tu Jing were reversed. By comparing the materia medica illustrations related to regional names in Da Guan Ben Cao by Liu Jia and Zheng He Ben Cao by Zhang Huicun, the name and the illustration of "Jin Zhou Bei Mu" in Zheng He Ben Cao by Zhang Huicun was more believable than "Yue Zhou Bei Mu" in Da Guan Ben Cao by Liu Jia. "Tai Zhou Wu Yao" and "Zhe Ba Wei", as genuine medicinal materials in Zhejiang, can be traced back to the illustrations of "Tai Zhou Wu Yao", "Yue Zhou Bai Zhu", "Mu Zhou Mai Dong", "Wen Zhou Peng 'e Shu", "Yue Zhou Bei Mu" and "Tian Tai Wu Yao" in Ben Cao Tu Jing. These findings provided text and drawing literature of herbs in the Song Dynasty for the research of genuine medicinal materials and their characteristics in Zhejiang province. They also showed that the utilization and development of the resources of traditional Chinese medicine in Zhejiang in the Northern Song Dynasty mainly focused on the coastal areas.

[Types of medicine paintings in herbaceous and woody medicines in Ben Cao Tu Jing].

A total of 568 paintings of herbaceous plants and woody plants as medicine were involved in Ben Cao Tu Jing, accounting for 60% of the total drug illustrations and 76% of the botanical medicine paintings. These medicinal paintings can be classified into four types: original plant paintings, medicinal material paintings, plant and medicinal material paintings, and plant and their habitat paintings. The original plant paintings can be specifically divided into five sections: the whole plant paintings with roots, partial aerial part paintings with roots, plant paintings with ground lines, rootless plant paintings, and broken branch paintings. Among them, the drawings of " the broken branch paintings " and " the whole plant paintings with roots " are consistent with the basic principles of collecting plant specimens. Additionally, "the plant and medicinal material paintings " and "the medicinal material paintings "reflect that they were drawn based on the market survey of medicinal materials or collected medicinal materials specimens. These medicine painting demonstrate rich characteristics of medicinal plants and medicinal materials and a high artistic quality with realistic details.These paintings in Ben Cao Tu Jing echoes Tu Jing, combine the art of painting with the cognition ofnatural science, as the rudiment of early paintings of plant science.

Adjuvant chemotherapy for patients with gastric neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas.

BACKGROUND: The aim of this study was to evaluate whether adjuvant chemotherapy is associated with improved survival in patients with resectable gastric neuroendocrine carcinomas (G-NECs) or mixed adenoneuroendocrine carcinomas (G-MANECs). METHODS: The study included patients with G-NECs or G-MANECs who underwent surgery in one of 21 centres in China between 2004 and 2016. Propensity score matching analysis was used to reduce selection bias, and overall survival (OS) in different treatment groups was estimated by the Kaplan-Meier method. RESULTS: In total, 804 patients with resectable G-NECs or G-MANECs were included, of whom 490 (60·9 per cent) received adjuvant chemotherapy. After propensity score matching, OS in the chemotherapy group was similar to that in the no-chemotherapy group. Among patients with G-NECs, survival in the fluorouracil (5-FU)-based chemotherapy group and the non-5-FU-based chemotherapy group was similar to that in the no-chemotherapy group. Similarly, etoposide plus cisplatin or irinotecan plus cisplatin was not associated with better OS in patients with G-NECs. Among patients with G-MANECs, OS in the non-5-FU-based chemotherapy group was worse than that in the no-chemotherapy group. Patients with G-MANECs did not have better OS when platinum-based chemotherapy was used. CONCLUSION: There was no survival benefit in patients who received adjuvant chemotherapy for G-NECs or G-MANECs.

ANTECEDENTES: El objetivo de este estudio fue evaluar si la quimioterapia adyuvante mejoraba la supervivencia en pacientes con carcinomas gástricos resecables neuroendocrinos (gastric neuroendocrine carcinomas, G-NECs) y carcinomas adenoneuroendocrinos mixtos (mixed adenoneuroendocrine carcinomas, G-MANECs). MÉTODOS: Se incluyeron pacientes con G-NECs y G-MANECs tratados quirúrgicamente en 21 centros en China entre 2004 y 2016. Se utilizó un análisis de emparejamiento por puntaje de propensión para reducir el sesgo de selección y el método de Kaplan-Meier para estimar la supervivencia global (overall survival, OS) de los pacientes en los diferentes grupos de tratamiento. RESULTADOS: En total, se incluyeron en el estudio 804 pacientes con G-NECs y G-MANECs resecables y 490 pacientes (60,9%) recibieron quimioterapia adyuvante. Después del emparejamiento por puntaje de propensión, la OS del grupo con quimioterapia fue similar a la del grupo sin quimioterapia. En los pacientes con G-NECs, la supervivencia en los grupos con quimioterapia basada en 5-FU (fluorouracilo) y de quimioterapia sin 5-FU fue similar a la del grupo sin quimioterapia. Asimismo, la combinación de etopósido y cisplatino o de irinotecán y cisplatino no se asoció con una mejor OS en pacientes con G-NECs. En pacientes con G-MANECs, la OS del grupo con quimioterapia sin 5-FU fue peor que la del grupo sin quimioterapia. Los pacientes con G-MANECs no presentaron una mejor OS cuando se administró quimioterapia basada en platinos. CONCLUSIÓN: La administración de quimioterapia adyuvante en pacientes con G-NECs y G-MANECs no mejoró la supervivencia.

[Risk factors of coloanal anastomotic stricture after laparoscopic intersphincteric resection for low rectal cancer].

Objective: To evaluate the risk factors of coloanal anastomotic stricture after laparoscopic intersphincteric resection (Lap-ISR) for patients with low rectal cancer. Methods: A retrospective case-control study was performed to collect clinicopathological data from a prospective database (registration number: ChiCTR-ONC-15007506) at the Department of Colorectal Surgery, the Characteristic Medical center of PLA Rocket Force. From June 2011 to August 2018, a total of 144 consecutive patients with low rectal cancer who underwent Lap-ISR were enrolled in the study. Inclusion criteria: (1) reconstruction of digestive tract by end-to-end hand-made coloanal anastomosis (HCAA); (2) distance from lower tumor margin to anorected sphincter ring < 1 cm and distance from lower tumor margin to intersphincteric groove ≥ 1 cm; (3) T1-3 stage tumor with expected negative circumferential resection margin evaluated by preoperative MRI or 3D endoanal ultrasound; (4) rectal cancer confirmed as well- or moderately-differentiated adenocarcinoma; (5) preoperative Wexner incontinence score >10 points. Exclusion criteria: (1) follow-up period less than 3 months; (2) multiple primary cancers; (3) undergoing colonic J-pouch, coloplasty or reconstruction of end-to-side coloanal anastomosis; (4) death within perioperative period (within 3 months after surgery). Coloanal anastomotic stricture was diagnosed if the index finger or 12 mm electronic colonoscope had obvious resistance through the anastomosis or new rectum, or could not pass, accompanied by clinical symptoms such as difficult defecation and anal incontinence. Degree of anastomotic stricture was divided into 3 grades: grade A required anal enlargement, laxative or enema to assist defecation without active surgical treatment; grade B required surgery or endoscopic intervention; grade C required definitive ostomy, including unreducible preventive ileostomy or permanent colostomy. Univariate and multivariate analysis were used to evaluate the effects of 28 variables, including baseline data (age, gender, body mass index, neoadjuvant therapy, etc.), tumor-related factors (distance between tumor low margin and anal edge, maximum diameter of tumor, TNM staging, etc.), surgery-related factors (operation time, intraoperative blood loss, ISR procedure, anastomotic height, etc.) and anastomotic leakage, on the postoperative coloanal anastomotic stricture. Univariate analysis used χ(2) test or Fisher's exact test, then factors with P<0.05 were further included in multivariate analysis using logistic regression. Results: A total of 144 patients were enrolled in the study, including 90 males and 54 females with a median age of 59 years and median BMI of 24.88 kg/m(2). R0 resection rate was 96.5% (139/144). Median tumor distal resection margin was 1.5 (0.5 to 3.0) cm. Median follow-up was 31.5 (4 to 86) months. Coloanal anastomotic stricture was observed in 19 patients (13.2%), including 3 cases (2.1%) of grade A, 9 cases (6.2%) of grade B, and 7 cases (4.9%) of grade C. The median interval from the initial surgery to diagnosis of anastomotic stricture was 7 (1 to 31) months. Univariate analysis showed that male (χ(2)=6.795, P=0.009), radiotherapy (χ(2)=13.330, P=0.001), operation type of ISR (χ(2)=7.996, P=0.013), and anastomotic leakage (χ(2)=10.198, P=0.004) were associated with the postoperative coloanal anastomotic stricture. Multivariate analysis further indicated that male (OR=5.975, 95% CI: 1.209-29.534, P=0.028), postoperative radiotherapy (OR=8.748, 95% CI: 2.397-31.929, P=0.001), and anastomotic leakage (OR=6.313, 95% CI: 1.834-21.734, P=0.003) were independent risk factor of postoperative coloanal anastomotic stricture. Conclusion: For male patients, or patients with postoperative radiotherapy or anastomotic leakage, close follow-up should be carried out to prevent postoperative coloanal anastomotic stricture following Lap-ISR.

[Evaluation of the effect of electrical stimulation combined with biofeedback therapy for postpartum pelvic organ prolapse: a static and dynamic magnetic resonance imaging study].

Objective: To explore the clinical value of static and dynamic magnetic resonance imaging (MRI) in evaluating the effect of electrical stimulation combined with biofeedback in the treatment of pelvic organ prolapse postpartum. Methods: A total of 50 primiparas diagnosed as pelvic organ prolapse postpartum from February 2016 to November 2017 were randomly divided into treatment group (24 cases) and control group (26 cases). The control group recovered spontaneously, and the treatment group received electric stimulation combined with biofeedback therapy (6 weeks). All subjects underwent static and dynamic MRI before and after treatment. The thickness of bilateral puborectal muscles, levator ani hiatus area (LHA), H line, M line and levator ani plate angle (LPA) were respectively measured in rest state and strain state at 42 days and 12 weeks postpartum, and the differences of parameters were compared between two groups. Results: (1) Compared with 42 days postpartum, the effective rate of pelvic organ prolapse was 15.4% (4/26) in the control group and 62.5% (15/24) in the treatment group, which was significantly higher than that of the control group (P<0.01). (2) Compared with 42 days postpartum, the thickness of bilateral puborectal muscles in the treatment group increased at 12 weeks postpartum, while that of the H line, LHA, M line and LPA in strain state decreased. (3) At 12 weeks postpartum, the thickness of the bilateral puborectal muscle in the treatment group was greater, and LHA, M line, and LPA in strain state were less than that in the control group (all P<0.05). Conclusion: Electrical stimulation combined with biofeedback therapy can improve pelvic organ prolapse due to vaginal delivery, and the static and dynamic MRI can objectively evaluate the effect of pelvic floor rehabilitation therapy on improving the pelvic floor supporting structure and function, providing an important support and guidance for restoration of postpartum pelvic organ prolapse.

Vitamin D and micro-inflammatory state in hemodialysis patients: a mini review and meta-analysis.

There is growing evidence that vitamin D (VitD) plays a role in the pathophysiological mechanism of every patient undergoing hemodialysis, and this role is significantly altered in a microinflammatory state. However, it is unclear whether supplementation dosage or route of administration should be altered due to this state. Thus, the objective of our mini review and meta-analysis was to re-consider supplementation of VitD in HD patients exhibiting micro-inflammatory state. Pubmed, Web of Science and Google Scholar were searched up to January 19, 2016. We included studies that evaluated supplementation in HD patients with micro-inflammatory state. One reviewer extracted data and one reviewer verified the data accuracy. We qualitatively summarized the main results and meta-analyzed data on comparable outcomes across studies. The main outcome measures were serum levels of VitD. Ten eligible studies were published between 2002 and 2016, involving a total 1,239 patients. Average vintage of hemodialysis was 35.36 (±31.08) months. We identified a high degree of clinical diversity (interventions and outcomes) and methodological heterogeneity (sample size and risk of bias) in included trials. The studies we reviewed provide some weak evidence to support VitD supplementation in patients on hemodialysis exhibiting micro-inflammatory state. We recommend that future trials focus on our main outcome measures (that is variable comparable across studies).

Brain grey matter abnormalities in medication-free patients with major depressive disorder: a meta-analysis.

BACKGROUND: Because cerebral morphological abnormalities in major depressive disorder (MDD) may be modulated by antidepressant treatment, inclusion of medicated patients may have biased previous meta-analyses of voxel-based morphometry (VBM) studies. A meta-analysis of VBM studies on medication-free MDD patients should be able to distinguish the morphological features of the disease itself from those of treatment. METHOD: A systematic search was conducted for the relevant studies. Effect-size signed differential mapping was applied to analyse the grey matter differences between all medication-free MDD patients and healthy controls. Meta-regression was used to explore the effects of demographics and clinical characteristics. RESULTS: A total of 14 datasets comprising 400 medication-free MDD patients and 424 healthy controls met the inclusion criteria. The pooled meta-analysis and subgroup meta-analyses showed robustly reduced grey matter in prefrontal and limbic regions in MDD. Increased right thalamus volume was only seen in first-episode medication-naive patients, and increased grey matter in the bilateral anterior cingulate cortex only in medication wash-out patients. In meta-regression analyses the percentage of female patients in each study was negatively correlated with reduced grey matter in the right hippocampus. CONCLUSIONS: By excluding interference from medication effects, the present study identified grey matter reduction in the prefrontal-limbic network in MDD. The subgroup meta-analysis results suggest that an increased right thalamus volume might be a trait directly related to MDD, while an increased anterior cingulate cortex volume might be an effect of medication. The meta-regression results perhaps reveal the structural underpinning of the sex differences in epidemiological and clinical aspects of MDD.

Late, severe, noninfectious diarrhea after renal transplantation: high-risk factors, therapy, and prognosis.

OBJECTIVE: Late severe noninfectious diarrhea in renal transplant recipients can lead to malnutrition and even graft loss. The purpose of this study was to evaluate risk factors associated with this condition and summarize therapy for these patients. METHODS: For more than 36 months we observed a cohort of 541 recipients who underwent kidney transplantation from January 2001 to June 2007. They were provided a calcineurin inhibitor (CNI) combined with mycophenolate mofetil (MMF). The four group includes a continuous cyclosporine (CsA); a preconversion to tacrolimus and a postconversion group as well as a continuous tacrolimus group. The rate of severe late noninfectious diarrhea was compared among the four groups. Risk factors were analyzed between the diarrhea and nondiarrhea cohorts. Clinical characteristics, efficacy, and safety were observed after modifying the immunosuppressive protocol for late severe noninfectious diarrhea recipients. RESULTS: Twenty-eight recipients presented with late sever noninfectious diarrhea. No patients displayed chronic diarrhea in the CsA (n = 145) or preconversion group (n = 95). The rate of diarrhea was 7.31% in the postconversion and 7.35% in the tacrolimus group. Using multivariate Cox proportional hazards analysis, factors associated with an increased risk of noninfectious diarrhea were cytochrome P450(CYP)3A5 *3/*3 type, chronic renal allograft dysfunction, and patient ingestion of Tripterygium wilfordii Hook F. All diarrheal recipients experienced weight loss, hypoalbuminia, and an increased serum creatinine. All affected patients underwent adjustment of the immunosuppressive regimen to achieve remission. Renal allograft survival in recipients with diarrhea was worse than that in nondiarrheal recipients receiving tacrolimus combined with MMF. CONCLUSION: Tacrolimus with MMF increased the risk of late severe noninfectious diarrhea among renal transplant recipients compared with hosts treats with CsA plus MMF. The CYP3A5 *3/*3 type, chronic renal allograft dysfunction, and T. wilfordii supplementation were high-risk factors for late diarrhea. Prompt adjustment of immunosuppression was an effective, feasible therapy for these patients.

First Report of Target Leaf Spot Caused by Corynespora cassiicola on Balsam Pear in China.

Balsam pear (Momordica charantia L.) is an economically important vegetable in China with increasing interest as a medicinal plant. In December of 2006, a new foliar disease caused by Corynespora cassiicola was observed on balsam pear growing in greenhouses in Shouguang City, Shandong Province, China. The disease occurred on 35% or less of the plants. Leaves of affected plants developed off-white halos surrounding circular lesions that were 1 to 5 mm broad. The lesions became dark brown, necrotic with concentric rings, and up to 15 mm in diameter. Severely affected plants eventually wilted and defoliated. Pieces of tissue from the leading edges of lesions were disinfected in 1% NaOCl for 1 min, rinsed in sterile water, and plated on potato dextrose agar. Colonies of the fungus were gray to dark green. Conidiophores were erect and simple, pale brown to brown, and 100 to 450 µm long and 3 to 8 µm wide. Conidia were obclavate to cylindrical, pale olivaceous brown to dark brown, smooth, 35 to 100 × 8 to 12 µm, and were produced in chains. On the basis of these characteristics, the fungus was identified as Corynespora cassiicola (1). The internal transcribed spacer (ITS) region of rDNA was amplified with primers ITS1/ITS4 and deposited in GenBank (Accession No. GQ381292). It was an exact match for a sequence of C. cassiicola previously deposited (Accession No. EU364555). To confirm pathogenicity, 30 1-month-old healthy seedlings of balsam pear were inoculated by spraying a suspension of conidia (1 × 105 conidia per ml) of one isolate of C. cassiicola until runoff. Ten seedlings were sprayed with sterile water as controls. Plants were kept in a humidity chamber at 27°C overnight and then placed in a growth chamber at 27°C. After 7 days, symptoms identical to those described above were observed, while no symptoms developed on the control plants. The pathogen was reisolated from inoculated leaves. C. cassiicola causes foliar diseases on many plants, including tomato, eggplant, soybean, and cucumber (2). There is one report on balsam pear in Korea (3). To our knowledge, this is the first report of target leaf spot caused by C. cassiicola on balsam pear in China. References: (1) M. B. Ellis. CMI Mycol. Pap. No. 65, 1957. (2) M. B. Ellis et al. CMI Mycol. Pap. No. 303, 1971. (3) J. H. Kwon et al. Plant Pathol. J. 21:164, 2005.

Comparative efficacy as antioxidants between ascorbic acid and epigallocatechin gallate on cells of two human lymphoblastoid lines.

Both ascorbic acid and epigallocatechin gallate, which is one of the key polyphenols contained in green tea leaves, have been considered excellent antioxidants. The present study compared the efficacy as antioxidants between the two agents on an equimolar basis. Cells of two lymphoid lines were used as test material to determine the reduction of chromosome damage induced by the radiomimetic antibiotic bleomycin. Without bleomycin, both agents, at concentrations of 10(-7), 10(-6), 10(-5), and 10(-4) M, showed chromosome damage similar to the untreated controls. With bleomycin, the weakest concentration of both showed no protective effect. At concentrations of 10(-6) and 10(-5) M, especially the latter, a significant reduction in frequencies of chromatid breaks was recorded. However, at the highest concentration, 10(-4) M, the chromatid break frequencies rose to the same level as that of cells treated with bleomycin alone, suggesting that both behaved like pro-oxidants.

Zinc protoporphyrin, zinc ion, and protoporphyrin reduce focal cerebral ischemia.

BACKGROUND AND PURPOSE: Zinc protoporphyrin pretreatment protects against temporary focal ischemic brain injury in rats. However, it is not known whether the zinc or the protoporphyrin portion of zinc protoporphyrin has effects on focal cerebral ischemia. Hence, all three agents were compared with regard to infarct size and edema in a rat model of middle cerebral artery occlusion. METHODS: Four groups of adult male Sprague-Dawley rats were subjected to 2 hours of temporary middle cerebral artery occlusion followed by 22 hours of reperfusion. Each group was pretreated 30 minutes before middle cerebral artery occlusion with 0.9% NaCl, and then three groups were given equimolar doses of zinc protoporphyrin, zinc chloride, or protoporphyrin, respectively. Regional cerebral blood flow in the ischemic cortex was monitored with a laser Doppler flowmeter. Cerebral infarct size, brain water content, and ion content were measured 24 hours after the onset of occlusion. RESULTS: Regional cerebral blood flow during middle cerebral artery occlusion was approximately 9.2% to 13% of baseline in all four groups. Brain water content in the infarcted zone after temporary focal ischemia in control, zinc protoporphyrin, zinc chloride, and protoporphyrin groups was 85.7%, 80.6%, 85.6%, and 81.4%, respectively. Brain sodium content in the same areas in all four groups paralleled the water content. Infarct size in the controls and groups treated with zinc protoporphyrin, zinc, and protoporphyrin was 25.6%, 7.2%, 7.6%, and 7.2%, respectively. Compared with the control group, the infarct volume in all three treated groups was significantly reduced (P < .05). CONCLUSIONS: The present results indicate that zinc protoporphyrin, but also zinc and protoporphyrin, contribute to brain-protective effects when administered early in a temporary focal ischemia model. Zinc chloride reduced infarct size but not edema formation when compared with zinc protoporphyrin and protoporphyrin. Zinc ion in vivo has brain-protective effects, confirming in vitro studies previously reported by some but contrary to reports of others. Blood versus brain neuropil and cell body concentrations of zinc ion need to be studied in the future to define the precise role of zinc in the complex mechanisms involved in brain ischemia.

[Clinical and experimental study of benign prostatic hyperplasia with intraglandular injection of chuan shen tong].

1038 cases of benign prostatic hyperplasia (BPH) were treated by injection of Chuan Shen Tong (CST), a Chinese herbal medicine, into the prostate gland. At the end of treatment the effective rate was 96%. After the treatment the BPH with urodynamic measurement was studied and it was found that the peak flow rate and mean flow rate increased 18% and 41.8% respectively. Transabdominal and transrectal ultrasonographies were used to measure the shrinkage of prostate's size after the injection treatment to be 0.51 and 0.4 cm (mean diameter) respectively. Animal model of BPH was established by the testosterone propionate. The prostatic weight and prostatic index was measured in mice after the injection of CST, it significantly decreased compared with that of the control (P < 0.01). The pathological findings: The hyperplastic papillae disappeared and the body of prostate markedly shrank in size. Experiment dogs has been carried out for the prostate quantitative analysis. The result revealed that the prostate parenchyma and intercellular substance shrank to 26.8% and 4.5% respectively.