TCM syndrome differentiation in colorectal cancer patients assisted by differences in gut microbiota: An exploratory study.

Objective: To explore the difference in gut microbiota between different traditional Chinese Medicine (TCM) syndromes in patients with colorectal cancer (CRC) and its internal relationship. Methods: From June 2020 to August 2021, 109 colorectal cancer patients with a clear pathological diagnosis who had not yet undergone surgery or chemotherapy were classified according to the TCM syndrome classification, and the feces samples of 109 patients with preoperative colorectal cancer were collected. 16s rRNA gene sequencing was used to determine gut microbiota diversity and abundance in CRC patients with different TCM syndrome, and LEfSe analysis was made to screen different TCM syndrome for differential representative microbiota. Results: 109 patients were divided into 5 syndromes by TCM syndrome classification, which were Liver and Kidney Yin Deficiency Syndrome (LKYDS, n = 19), Spleen Deficient Qi Stagnation Syndrome (SDQSS, n = 30), Stasis and Poison Obstruction Syndrome (SPOS, n = 17), Damp-Heat Syndrome (DHS, n = 30), Qi and Blood Deficiency Syndrome (QBDS, n = 13). Alpha diversity index showed significant differences among the five groups of TCM syndromes, with Shannon index being highest in the SDQSS group and lowest in the LKYDS (p = 0.003). ACE index being highest in the SDQSS group and lowest in the SPOS (p = 0.010). PD whole tree index being highest in the SDQSS group and lowest in the SPOS (p = 0.017). Similarly, beta diversity showed significant differences among the five groups of TCM syndromes, with principal coordinate analysis (PCo1 = 31.86 %, PCo2 = 5.62 %) showing separation and coincidence between the groups, and Adonis group differences showing coincidence between the QBDS-LKYDS (p = 0.702), QBDS-DHS (p = 0.133), and SDQSS-DHS (p = 0.260) groups. LEfSe analysis revealed that the representative microbiota of DHS patients was Dialister sp Marseille P5638 (LDA = 3.05, p＜0.001), the representative microbiota of SPOS patients was Oscillospirales (LDA = 4.78, p = 0.029), the representative microbiota of SDQSS patients was Selenomonadaceae (LDA = 3.94, p = 0.003), the representative microbiota of LKYDS patients was Dialister (LDA = 4.19, p = 0.001), and the representative microbiota of QBDS patients was Akkermansia muciniphila (LDA = 4.23, p = 0.006). Conclusions: There are significant differences in gut microbiota between different TCM syndromes in CRC patients. The five microbiota, Dialister sp Marseille P5638, Oscillospirales, Selenomonadaceae, Dialister, and Akkermansia muciniphila, may be differential markers of TCM syndrome in CRC and are expected to be one of the bases for accurate TCM syndrome differentiation of CRC.

Diversity of carotenoid composition, sequestering structures and gene transcription in mature fruits of four Prunus species.

The genus Prunus contains many fruits used in the human diet, which exhibit a variety of different flavors. However, publications on the diversity of carotenoid profiles and sequestering structures in Prunus fruits are limited. In this study, carotenoids and their associated sequestering structures in mature fruits of four Prunus species, including peach [Prunus persica (L.) Batschi], nectarine [Prunus persica (L.) Batschi var. nucipersica], plum (Prunus salicina L.), and apricot (Prunus armeniaca L.) were investigated. HPLC-PAD analysis revealed that mature fruits all accumulated carotenoid esters, while their profiles and levels differed significantly. Transcription analysis suggested a positive correlation between carotenogenic genes and carotenoid profiles. Transmission electron microscopy (TEM) analysis revealed a common globular chromoplast in Prunus. However, the number and size of plastids and plastoglobules varied between species. Noticeably, the white-flesh Ruiguang 19 nectarine contained plastids similar to chromoplasts, except with smaller plastoglobules. In addition, it seemed like a lipid-dissolved ß-carotene form in apricot fruits, which is more effectively absorbed by humans than the solid-crystalline form. Moreover, the lowest transcriptions of plastid-related genes were found in Friar plum, and GLK2 and OR genes were presumed to be associated with the largest chromoplasts observed in apricot. We investigated the correlations among carotenoid accumulation, plastid characteristics and gene transcription and found that chromoplast development is likely more important in determining carotenoid accumulation than carotenogenic transcription in Prunus fruits. This study presents the first report on the diversity of carotenoid sequestering structures in Prunus fruits and suggests some crucial genes associated with diversity.

The association of lecithin retinol acyltransferase and the 25(OH)D receptor with pediatric overweight and obesity.

The aim of this study is to determine whether lecithin retinol acyltransferase (LRAT) as well as biomarkers of vitamin A (VA) and vitamin D are related to indices of obesity in childhood. A total of 164 children (aged 6-12 years, female 49.39%), comprising 66 children in the overweight/obese group and 98 children in the lean group, were included. LRAT expression was remarkably lower in the overweight/obese group than in the lean group (P < 0.01). Compared with the lean group, the overweight/obese group had elevated VA (0.95 ± 0.25 vs. 0.83 ± 0.21 µmol/L, P < 0.01). Moreover, the levels of 25(OH)D (25-hydroxyvitamin D) and its receptor were lower in overweight/obese subjects than in lean subjects (P = 0.06 and <0.05). LRAT was negatively correlated with body mass index and waist circumference (R = -0.27, P < 0.01, and R = -0.18, P < 0.05, respectively) and positively correlated with high-density lipoprotein (R = 0.18, P < 0.05). VA metabolism may be disordered in obese children, although children with obesity have higher VA levels than lean children.

Astragalus polysaccharide inhibits IDO1 expression in colon tumor microenvironment to increase intratumoral CD8~+ T cell infiltration / 中国中药杂志

This study aims to investigate the regulatory effects of Astragalus polysaccharide(APS) and APS combined with 5-fluorouracil(5-FU) on indoleamine-2,3-dioxygenase(IDO1) in the colon tumor microenvironment. Sixty Balb/c mice were randomized into a blank group, a model group, an APS group, an APS + 5-FU group, an APS + low-dose 5-FU group, and a 5-FU group. A tumor model was established by subcutaneous transplantation with CT-26 mouse colon cancer cells in other groups except the blank group. After successful modeling, each group was treated with corresponding drugs for 7 days. The general condition, body weight, and tumor volume of the mice were observed and measured daily during the treatment period. The mice were sacrificed at the end of treatment, and the tumor suppression rate and spleen index of the mice were calculated. Western blot and fluorescence quantitative PCR were employed to determine the protein and mRNA levels, respectively, of IDO1 in the tumor tissue of mice. High performance liquid chromatography was employed to measure the levels of tryptophan(Trp) and kynurenine(Kyn) in the tumor tissue of mice. Hematoxylin-eosin(HE) staining was performed to observe the histological changes of the tumor tissue, and immunohistochemistry to detect the changes of CD4 and CD8 expression in the tumor tissue. Compared with that in the model group, the tumor volume of mice in each treatment group significantly reduced. The body weights of mice in APS + 5-FU group and 5-FU group significantly reduced from day 4 to day 7 of treatment. In addition, the APS + 5-FU group and 5-FU group showed significantly decreased spleen index. The protein and mRNA levels of IDO1 were significantly down-regulated in the APS, APS + 5-FU, and APS + low-dose 5-FU groups. The drug interventions significantly increased the Trp content and decreased the Kyn content. The APS + 5-FU group showed significantly reduced infiltration of CD4~+ T lymphocytes and increased infiltration of CD8~+ T lymphocytes. APS inhibited the expression of IDO1 in the colon tumor microenvironment to increase CD8~+ T lymphocyte infiltration, and the combination of APS with 5-FU demonstrated better effect.

Research progress of lung aging in chronic respiratory diseases / 生理学报

Cell aging is an extremely complex process, which is characterized by mitochondrial structural dysfunction, telomere shortening, inflammatory microenvironment, protein homeostasis imbalance, epigenetic changes, abnormal DNA damage and repair, etc. Aging is usually accompanied by structural and functional damage of tissues and organs which further induces the occurrence and development of aging-related diseases. Aging includes physiological aging caused by increased age and pathological aging induced by a variety of factors. Noteworthy, as a target organ directly contacting with the outside air, lung is more prone to various stimuli, causing pathological premature aging which is lung aging. Studies have found that there is a certain proportion of senescent cells in the lungs of most chronic respiratory diseases. However, the underlying mechanism by which these senescent cells induce lung senescence and their role in chronic respiratory diseases is still obscure. This paper focuses on the causes and classification of lung aging, the internal mechanism of lung aging involved in chronic respiratory diseases, and the application of anti-aging treatments in chronic respiratory diseases. We hope to provide new research ideas and theoretical basis for the clinical prevention and treatment in chronic respiratory diseases.

Category of Chinese medicine registration:historical evolution,current status,and problems / 中国中药杂志

The development of traditional Chinese medicine(TCM) has always been highly valued and supported since 1949. However, Chinese medicine industry still faces great challenges in view of the current status of the industry and registration and approval of new products in recent years. Related policies also directly influence the development of the industry. The latest version of the Provisions for Drug Registration and Requirement on Registration Classification and Application Information of Traditional Chinese Medicines have been put into practice since 2020. Registration classification is the core content of the Chinese medicine registration management system, as it is closely related to the research, development, and registration of Chinese medicine and the innovative development of the industry. This article aims to systematically review the historical evolution of the category of Chinese medicine registration and analyze the current status and problems, which is expected to provide a reference for the formulation of supporting documents according to related laws and regulations.

Thoughts on path of R&D and registration of innovative traditional Chinese medicine with synchronous transformation of "series prescriptions" / 中国中药杂志

Since the implementation of drug registration in China, the classification of Chinese medicine has greatly met the needs of public health and effectively guided the transformation, inheritance, and innovation of research achievements on traditional Chinese medicine(TCM). In the past 30 years, the development of new Chinese medicine has followed the registration transformation model of " one prescription for single drug". This model refers to the R&D and registration system of modern drugs, and approximates to the " law-abiding" medication method in TCM clinic, while it rarely reflects the sequential therapy of syndrome differentiation and comprehensive treatment with multiple measures. In 2017, Opinions on Deepening the Reform of Review and Approval System and Encouraging the Innovation of Drugs and Medical Devices released by the General Office of the CPC Central Committee and the General Office of the State Council pointed out that it is necessary to " establish and improve the registration and technical evaluation system in line with the characteristics of Chinese medicine, and handle the relationship between the traditional advantages of Chinese medicine and the requirements of modern drug research". Therefore, based on the development law and characteristics of TCM, clinical thinking should be highlighted in the current technical requirements and registration system of research and development of Chinese medicine. Based on the current situation of registration supervision of Chinese medicine and the modern drug research in China, the present study analyzed limitations and deficiency of " one prescription for single drug" in the research and development of Chinese medicine. Additionally, a new type of " series prescriptions" was proposed, which was consistent with clinical thinking and clinical reality. This study is expected to contribute to the independent innovation and high-quality development of the TCM industry.

A New Subgroup of Rhizoctonia AG-D, AG-D III, Obtained from Japanese Zoysia Grass Exhibiting Symptoms of a New Disease.

Isolates of an unidentified Rhizoctonia sp. (UN isolates) were obtained from Japanese zoysia grass (Zoysia japonica Steud) that exhibited symptoms of a new sheath rot disease. UN isolates were binucleate and showed hyphal fusion with tester isolates of Rhizoctonia anastomosis group (AG)-D. Those isolates were compared with isolates of subgroups I and II of Rhizoctonia AG-D based on cultural morphology, hyphal growth rate at different temperatures, anastomosis frequency, pathogenicity, and sequence analysis of the internal transcribed spacer (ITS) region of ribosomal DNA genes (rDNA-ITS region). The mycelial color of UN isolates was light yellow which differs from AG-D I but is similar to AG-D II. Sclerotia of UN isolates were dark brown in color and larger in size (1 to 3 mm in diameter) than those of AG-D subgroup I (1 mm in diameter), whereas isolates of AG-D II produced white mycelial clamps 4 to 5 mm in size. Hyphal growth rate of UN isolates was slower than that of two AG-D subgroups at several temperatures, especially 25°C. In pathogenicity tests on Japanese zoysia grass, UN isolates showed moderate disease severity and lower pathogenicity than isolates of AG-D subgroups I and II. Sequences of the rDNA-ITS region within UN isolates were almost homologous, but had lower homology with subgroups AG-D I or II. Phylogenetic trees constructed using ITS sequences showed that UN isolates formed an individual cluster that differed from the clusters of the two subgroups. We propose that UN isolates are a new subgroup of Rhizoctonia AG-D, subgroup III, and the name of the disease is "spring-rot" on Japanese zoysia grass.

Research progress of respiratory syncytial virus (RSV) infection and respiratory diseases in infancy / 生理学报

Lower respiratory tract infection (LRTI) induced by respiratory syncytial virus (RSV) is an important cause of hospitalization for infants. Compared with adults, infants are more likely to cause serious respiratory diseases after RSV infection due to the specific immature airway structure and immune system. The balance of immune resistance and immune tolerance of the host is critical to effective virus clearance and disease control. This paper reviews the relationship between RSV infection and respiratory diseases in infancy, the influence factors of the high pathogenicity of RSV infection in early life, as well as the research progress of anti-RSV therapy, and expands the specific molecular events regulating immune resistance and immune tolerance. We expect to present new ideas for the prevention and treatment of RSV-related respiratory diseases in clinical practice.

Research of Anticancer Realgar Preparations from Perspective of Patent / 中国实验方剂学杂志

To review the research progress of anticancer realgar preparations from the perspective of patent，in order to provide a reference for the research of new antitumor realgar drugs. IncoPat database was retrieved with keywords plus IPC classification number. Original data and 72 patents of anti-cancer realgar preparations were obtained and included after artificial denoising. The quantitative analysis was made on the information about application trends，application types and patentee. The technical points of representative patents were summarized. ① The patent types of anticancer realgar preparations are mainly product patents. Its technological innovation has undergone the development of realgar compound agents，arsenic sulfide single agents，nanometer products of realgar agents，bioleaching of realgar preparations，compound realgar extract preparations，compound nano realgar preparations and arsenic sulfide polymorphic crystalline structure. ② Nano realgar agents， realgar bioleaching preparations， new crystalline type realgar preparations and realgar compound preparations. ③ The following studies should be strengthened in the future，involving the comparison of biological effects and toxicity of nano realgar preparations of different preparation processes，the selection of optimal particle size，the druggability of realgar bioleaching preparations，the discovery of new As4S4 crystalline forms and the secondary development of anticancer realgar preparations.

Time of dissociation between microcirculation, macrocirculation, and lactate levels in a rabbit model of early endotoxemic shock / 中华医学杂志(英文版)

BACKGROUND@#The relationship between macrocirculation and microcirculation remains controversial. The loss of coherence between microcirculation and macrocirculation has already been found in late-stage sepsis shock. The objective of this study was to determine the earliest possible time of detecting the loss of coherence between microcirculation and macrocirculation in early-stage endotoxemic shock.@*METHODS@#We randomized 24 female New Zealand white rabbits into two groups: endotoxemic shock group (n = 14) and control group (n = 10). Rabbits in the endotoxemic shock group were equipped with arterial and venous catheters and received an intravenous infusion of Escherichia coli lipopolysaccharide (LPS, 2 mg/kg over 10 min). Rabbits in the control group received the same dose of saline infusion. Microcirculatory perfusion parameters were assessed in the sublingual mucosa using sidestream dark-field video microscopy. Systemic hemodynamics and blood lactate levels were measured at baseline and over a 120-min period.@*RESULTS@#Ninety minutes after completing LPS infusion, all animals in the endotoxemic shock group developed a hypodynamic septic condition, characterized by low cardiac output and increased systemic vascular resistance; 120 min after completing LPS infusion, the mean arterial pressure decreased by 25% (P = 0.01), confirming ongoing endotoxemic shock. However, significant decreases in sublingual microcirculatory parameters of small vessels (microvascular flow index, perfused vessel density, and proportion of small perfused vessels) were observed 30 min after completing LPS infusion (P = 0.01, for all), and threshold decreases of 30% were found 60 min after completing LPS infusion (P = 0.001, for all) in the endotoxemic shock group. Lactate levels significantly increased to more than 2 mm/L at 90 min and more than 4 mm/L at 120 min in the endotoxemic shock group (P = 0.02 and P = 0.01, respectively).@*CONCLUSIONS@#Changes in microcirculatory perfusion precede changes in macrocirculation and lactate levels in a rabbit model of endotoxemia shock. Microcirculation, macrocirculation, and oxygen metabolism are distinct in early-stage endotoxic shock.

Complete Genome Sequence of a Hepatitis D Virus Genotype 1 Strain Isolated in Guangdong, China.

Here, we report the first complete genome sequence of a hepatitis D virus genotype 1 strain, GZ37, isolated in Guangzhou, Guangdong Province, China, in 2014. The sequence information provided here will help us understand the molecular epidemiology of hepatitis D virus and contribute to disease control in mainland China.

Comparison of graft vessel versus native vessel strategies for late saphenous vein graft disease after coronary artery bypass grafting / 中华心血管病杂志

Objective: To compare clinical efficacy of interventional treatment with graft vessel and native coronary artery for patients with late saphenous vein grafts disease(SVGD) after coronary artery bypass grafting (CABG). Methods: A total of 1 608 patients underwent CABG in Tianjin Chest from March 2014 to December 2017 were screened. During the follow-up period, 165 hospitalized patients with recurrence of angina pectoris within one year after CABG, who had at least one narrow vein graft(≥50%) confirmed by the coronary angiography were enrolled. According to the results of angiography and surgeon's clinical experiences, the patients received interventional treatment to vein grafts(grafts group, n=53) or native coronary vessels(native group, n=112). The operation success rate, mortality and incidence of serious complications after interventional treatment in two groups at the time of hospitalization were compared.And the incidence of major adverse cardiovascular events(MACE) in two groups at one year after discharge were also compared. Kaplan-Meier survival curve was used to compare the cumulative event-free survival rates. The risk factors for the MACE in the patients with late SVGD and treated by interventional therapy were analyzed by Cox regression analysis. Results: A total of 165 patients were included for analysis, including 98 males(59.4%). The age was (64.2±7.1) years old. The follow-up time was 12 (8, 12) months. In the grafts group, operation success rate was 90.57%(48/53), and 3 cases(5.66%) suffered from serious complications after interventional treatment, 2 cases(3.77%) died. For native group the operation success rate was 88.39%(99/112), and 7(6.25%) cases suffered from serious complications after interventional treatment, and no deaths. The operation success rate and the incidences of serious complications after interventional treatment in two groups had no statistically significant difference(both P>0.05). The mortality in hospital of native group was lower than that in grafts group(P<0.05). Within 12 months after discharge, there was no statistically significant difference in incidence of MACE of two groups (11.32%(6/53) vs. 10.71%(12/112), P>0.05). Survival analysis showed that the cumulative event-free survival rates in two groups were 73.58% (39/53) and 66.13%(74/112), and there was no statistically significant difference (P>0.05). Cox regression analysis showed acute coronary syndrome (HR=41.203, 95%CI 4.859-349.361, P<0.01), and peripheral vascular diseases (HR=2.808, 95%CI 1.067-7.393, P<0.05) were the risk factors of the MACE for the patients treated by interventional therapy with late SVGD. Conclusion: For the patients with late SVGD after CABG, the success rate of intervention with vein grafts and own coronary vessels are both high with satisfactory safety.The in-hospital mortality of interventional therapy in own coronary vessels is lower than in graft vessel. Patients with acute coronary syndrome and peripheral vascular disease have a poor prognosis.

Enlightenments of Padma Circosan Capsules to registration of compound Chinese materia medica products in European Union / 中草药

The European Union (EU) law 2004/24/EC has simplified the registration of traditional herbal medicines, which makes it possible for Chinese materia medica (CMM) to enter the EU as medicines. To register CMM products in the EU is an important way to realize the internationalization of CMM. Compound combination is the main clinical application form of CMM under the guidance of CMM syndrome differentiation. How to register compound CMM products in EU has become one of the important realistic topics for the internationalization of CMM. A total of 630 applications for traditional herbal medicinal products have been approved by the EU member states since the implementation of the Directive 2004/24/EC in 2005. Among these products, Padma Circosan Capsules was the only approved one originated from CMM area. The course of this product lead us with the enlightenment for the compound CMM products in three aspects: The literatures and evidence about safety and traditional use of "related product" are the core components in the non-clinical and clinical application materials for the registration of both combination and mono-component CMM products; The traditional application and safety evidence of "related products" as well as the relevant materials and data of EU monograph constitute the important content for the registration and approval of compound CMM products in EU member states; Applicants should pay more attention to the study of genotoxicity and the systematic collection of post-marketing pharmacovigilance data.

Pure red cell aplasia in children: a clinical analysis of 16 cases / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features, treatment, and prognosis of pure red cell aplasia (PRCA) in children.@*METHODS@#A retrospective analysis was performed for the clinical data of 16 children with PRCA. The outcome and prognosis of patients treated with prednisone combined with Huaiqihuang granules versus prednisone alone were evaluated.@*RESULTS@#All the 16 children complained of symptoms of anemia including pale or sallow complexion. Of 12 children undergoing pathogen test, 7 (58%) were found to have pathogen infection, among which human cytomegalovirus was the most common. Lymphocyte subsets were measured for 7 children, among whom 5 (71%) had lymphocyte immune disorder. Six children were found to have abnormalities in immunoglobulin and complement. The 8 children treated with prednisone combined with Huaiqihuang granules had a median follow-up time of 21.5 months, among whom 1 was almost cured, 1 was relieved, and 6 were obviously improved; the median onset time of treatment was 1 month, and 2 children had disease recurrence in the course of drug reduction or withdrawal. The 8 children in the prednisone alone treatment group had a median follow-up time of 34 months, among whom 4 were almost cured, and 4 were obviously improved; the median onset time of treatment was 2.5 months, and 4 children had recurrence during drug reduction or withdrawal.@*CONCLUSIONS@#Children with PRCA usually complain of anemia-related symptoms. Laboratory tests show pathogen infection in some children with PRCA, and most of children have immune disorders. Glucocorticoids have a good therapeutic effect, but some children relapse in the course of drug reduction or withdrawal. Combined treatment with prednisone and Huaiqihuang granules may have a faster onset of action and less possibility of recurrence.

Clinical application of Phloroglucinol combined with Dexamethasone in ureteroscopy lithotripsy / 中国内镜杂志

Objective To evaluate the clinical effect of Phloroglucinol combined with Dexamethasone in ureteroscopy lithotripsy. Methods Patients with severe urinary infection, urinary tract tuberculosis, congenital urinary tract malformation were excluded. The clinical data of 124 patients with ureteral calculus was retrospectively analyzed, Group control with 29 patients who underwent conventional ureteroscopy lithotripsy, 32 patients were given Phloroglucinol (80 mg) as Group phloroglucinol, 29 patients were given Dexamethasone (10 mg) as Group Dexamethasone, 34 patients were given combination drugs of Phloroglucinol (80 mg) plus Dexamethasone (10 mg) as Group combination therapy, intravenously 15 min prior to surgery, respectively. The surgical complication, side-effects, operation time, duration of postoperative hematuria, and expulsion rate were recorded. Results All surgeries were accomplished successfully, and none severe side-effects were observed among these cases. In comparison of operation time and duration of postoperative hematuria, there were no significant difference between group Dexamethasone and group control, and both group Phloroglucinol and group combination therapy were better than that of group control (P < 0.05), furthermore, group combination therapy was better than group phloroglucinol (P < 0.05). In comparison of the expulsion rate, there were no significant difference between group control and group Phloroglucinol or group Dexamethasone (P > 0.05), however, group combination therapy is better than that of group control (P = 0.017). Conclusion Combined treatment with Phloroglucinol and Dexamethasone in ureteroscopy lithotripsy would shorten the operation time and duration of postoperative hematuria significantly, and improve the expulsion rate eventually.

Analysis on value of Community Herbal Monograph in registration of traditional Chinese medicinal products in Europe / 中草药

The Community Herbal Monograph (CHM) is an official document which reflects the scientific opinion of European Medicines Agency (EMA) and plays an important role in technical harmonization of the herbal medicinal products. The role of CHM is very similar with the centralized procedure in the EU level as it represents the technical coordination results of the assessment about safety and efficacy of herbal medicine. The monograph and national procedure, decentralized procedure, and mutual recognition procedure together constitute the coexistence characteristic of centralization and decentralization of the EU medical legislation. The CHM and the traditional herbal medicine registration also constitute the core content of Directive 2004/24/EC in the EU and member state level respectively. And the CHM plays an important role in the registration of traditional herbal medicinal products in the EU member state. However, it has not yet been fully studied by domestic experts and scholars. This paper makes intensive studies on the value of CHM and analyzes the application of monograph in traditional herbal medicine registration. The purpose is to clarify the value and importance of CHM in the registration of traditional Chinese medicine in EU and to provide reference for the Chinese enterprises which are aspiring to open up the EU market.

Culture Narrative Analysis of Terminal Stage Patients: Based on the Field Investigation in X Community Health Service Center in Harbin / 中国医学伦理学

This paper collected the case and interview data in the hospice wards of X Community Health Service Center in Harbin with the method of participant observation and in-depth interview.It sorted and analyzed the disease narrative,psychological experience and social-cultural significance of terminal stage patients.Through describing three field cases,this paper analyzed the depressed-helpless and request-desire pain experience in terminal stage patients.It emphasized the cultural narrative research in this special group,terminal stage patients,and further to provide realistic basis for the improvement of hospice care in China.

Thought of Nursing Environment in China Based on Donabedian Quality Theory / 中国医院管理

Based on the theory of Donabedian quality theory,namely structure-process-outcome theory,the evaluation and maintenance of nursing environment is analyzed.Through related websites,retrieval of patient safety case and literature and combined with the relationship with three layers,the high quality nursing environment and patient safety is analyzed,to study its localization and reference,and to put forward the corresponding suggestions in order to help ensure the safety of patients.

The study on the correlation of serum levels of tumor necrosis factor with memory in the patients with chronic insomnia disorder / 中国神经精神疾病杂志

Objective To explore the changes of serum levels of tumor necrosis factors (sTNF-α and sTNF-β) and their soluble receptors (sTNF-R1 and sTNF-R2), and analyze their relationship with sleep quality and memory in patients with chronic insomnia disorder (CID). Methods Forty-four CID patients and 39 normal controls were enrolled. Pittsburgh Sleep Quality Index (PSQI) and Nine-Box Maze Test were used to assess the insomnia severity and memory functions, respectively. The serum levels of sTNF-α, sTNF-β, sTNF-R1 and sTNF-R2 were examined using protein-chip technology. Results Compared to the controls, CID patients had significantly higher number of errors in spatial working (Z=5.362, P<0.001) and object recognition memories (Z=3.260, P=0.001) in the Nine-Box Maze. In addition, CIDpatients had higher levels of sTNF-αand sTNF-β (Ps<0.001), and lower levels of sTNF-R1 and sTNF-R2 (Ps<0.001). The Spearmen correlation analysis showed that the levels of sTNF-α and sTNF-β were positively correlated with the scores of PSQI (Ps<0.001), whereas the levels of sTNF-R1 and sTNF-R2 were negatively correlated with the scores of PSQI (Ps<0.001). In the CID patients, sTNF-α levels were positively correlated with the errors in both spatial working (γ= 0.380, P=0.017) and object recognition (γ= 0.349, P= 0.030) memories, whereas sTNF-β levels were only positively correlated with the error in spatial working memory (γ=0.414, P=0.009). The levels of sTNF-R1 and sTNF-R2 were not correlated with memory performance (Ps>0.05). Conclusion CID patients have increased levels of sTNF-αand sTNF- whereas have decreased levels of R1 and R2. The elevated sTNF-α and sTNF-β levels are correlated with memory disorders in CID patients.