The relationship analysis and reaction mechanism of carbon, nitrogen, and phosphorus metabolism in sewage treatment in plateau habitat.

The efficiency of pollutant removal in sewage is mainly determined by the structure and abundance of microbial flora, which is essentially represented by the type and abundance of genes and enzymes, and the reaction mechanism is the abundance and degree of reaction of metabolic pathways and metabolic modules. In order to study the mechanism of carbon, nitrogen, and phosphorus metabolism of activated sludge microflora in the A2O process at high altitudes at different temperatures, so as to improve the removal rate of pollutants and reduce the discharge concentration of pollutants. Based on the research environment of high-altitude environmental research, the author used the A2O system as the treatment process and put Illumina MiSeq high-through sequencing technology to comprehensively dissect the reaction relationship of carbon, nitrogen and phosphorus metabolic pathways, and derived the main functional genes and enzymes of carbon, nitrogen, and phosphorus metabolism. It was demonstrated that the abundance of the most metabolic modules and functional genes tended to increase and then decrease with increasing temperature. In particular, the highest abundance and activity and the best pollutant removal efficiency were observed at 20 °C. This study will provide a valuable reference for the study of carbon metabolism, nitrogen metabolism, and phosphorus metabolism of microbial flora in sewage treatment under plateau habitats.

Connotation and Clinical Application of Tong （Dredging） Method in Treatment of Coronary Heart Disease / 中国实验方剂学杂志

Tong （dredging） method in traditional Chinese medicine （TCM） emphasizes soothing the stagnated Qi， blood， and body fluid in zang-fu organs， meridians， and collaterals to remove pathogens， reinforce vital Qi， and balance Yin and Yang of the human body. Tong method can be adopted to disperse sweat pore， attack pathogenic Qi， harmonize Yin and Yang， as well as tonify deficiency， and resolve stagnation. It has been proved effective in treating coronary heart disease （CHD）， which falls into the category of "chest impediment and heart pain" in TCM， with the key pathogenesis lying in blood vessel obstruction. Therefore， dredging blood vessels is the primary therapeutic principle for CHD. Specifically， there are four aspects. The first is dispersing and dredging the sweat pore of the heart. If the sweat pore is occluded by pathogenic cold， which makes Yang-qi undissipated， Cinnamomi Ramulus， Piperis Longi Fructus， Alpiniae Officinarum Rhizoma， and Asari Radix et Rhizoma can be prescribed for warming and dredging heart Yang. If the Yang-qi of the heart and chest stagnated in the body， which hinders Qi and blood to nourish the myocardium， resulting in chest pain， Poria and Alismatis Rhizoma can be prescribed. For CHD due to atherosclerosis and inflammation， heat-clearing， toxin-removing， and inflammation-resisting Chinese medicinal herbs such as Coptidis Rhizoma and Rhei Radix et Rhizoma are recommended. The second is attacking and dredging the collaterals of the heart. Salviae Miltiorrhizae Radix et Rhizoma， Chuanxiong Rhizoma， Notoginseng Radix et Rhizoma， etc. can be prescribed for blood stasis， Trichosanthis Fructus， Allii Macrostemonis Bulbus， Pinelliae Rhizoma， etc. for phlegm， and Aquilariae Lignum Resinatum， Euodiae Fructus， etc. for pathogenic cold. Since the chronic disease can affect collaterals， Moschus and Santali Albi Lignum can be added to promote blood circulation and remove the obstruction of collaterals of the heart. The third is harmonizing and dredging the mind. Cinnamomi Ramulus， Coptidis Rhizoma， Cinnamomi Cortex， etc. are selected for restoring the coordination between the heart and the kidney. According to the specific syndrome， the methods of nourishing the mind and calming the nerves through tranquilizing the mind， calming down the mind， and inducing resuscitation can be selected using such Chinese medicines as Ziziphi Spinosae Semen， Polygalae Radix， and Draconis Ossa. The fourth is tonifying and dredging the Qi and blood of the heart. The deficiency syndrome of CHD is divided into Qi deficiency and kidney deficiency. Invigorating Qi and strengthening the heart are the first essentials for the treatment of CHD. In Qi invigoration， Qi and blood must be strengthened simultaneously to strengthen the heart and clear the pulse. Hence， Bazhentang modified by Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos can be chosen. In kidney Qi tonifying， kidney and heart must be strengthened simultaneously， and the methods of tonifying kidney and activating blood can be used. Ginseng Radix et Rhizoma and Astragali Radix are considered as the first choice for tonifying heart Qi， and Epimedii Folium and Morindae Officinalis Radix for tonifying kidney Qi， which are added with Salviae Miltiorrhizae Radix et Rhizoma and Rehmanniae Radix Praeparata to obtain the kidney-tonifying and blood-activating prescription. It is suitable for treating CHD due to kidney deficiency and blood stasis. Simultaneous treatment of heart and kidney is more suitable for middle-aged and elderly patients and chronically ill patients. Tong method can be used in various clinical diseases as well as CHD.

Efficacy and safety of Shenyankangfu Tablet, a Chinese patent medicine, for primary glomerulonephritis: A multicenter randomized controlled trial / 中西医结合学报

BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.

Building of an Internet+supervision system for vendor-processed TCM herbal pieces decoction and delivery service / 中华医院管理杂志

Pace of life and work of people is accelerating nowadays, and hospitals keep improving their services, which gives rise to the decoction and delivery service from the third party vendors for traditional Chinese medicine(TCM).Given the quality control standards for the TCM decoction service as issued by Zhejiang and other regions, the systems of supervision and assessment remain incomplete.Authors of the paper introduced a project improvement team, composed of Chinese medicine pharmacy, Chinese medicine experience specialists, vendors of Chinese medicine decoction and express delivery companies, hence establishing a " three-in-one" supervision system of Internet+TCM decoction and delivery service. This practice can optimize the assessment indexes, strengthen the assessment system of assessment transformation and supervision system for patient medication.It proves that the practice contributes to higher quality and safety of TCM decoction and delivery service, improves the ability and level of TCM services, and ensures the medication safety of patients.

CircRNA as a new field in human disease research / 中国中药杂志

For the characteristics of high stability， high conservation between species， and tissue specificity， circular RNA(circRNA) has been expected to become a new molecular biomarker for the clinical diagnosis， treatment and prognosis， and the potential target for targeted therapy. Study on the traditional Chinese medicine(TCM) syndrome includes not only the macro indexes collected by using four traditional methods of diagnosis， but also contains some micro information that can not be achieved by using the four traditional diagnosis methods. The questions such as how to deal with the relationship between the holistic concept of TCM and micro research， and how to solve the contradiction between the fuzziness of syndrome description and the accuracy of microscopic research， need to be considered before the micro research in TCM syndrome. circRNA as a new field of understanding human disease， may provide some ideas for the TCM syndrome research due to its characteristics. Overall， it is necessary to pay attention to explore the molecular level with same syndrome in different diseases and reveal the connotation and essence of syndromes by understanding of circRNA.