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The Huaihe River Basin is located in the north-south climate transition zone of China. The change of carbon storage in this area is of great significance for predicting the future ecological protection, mitigating climate change, and maintaining sustainable development of the Huaihe River Basin. The middle and upper reaches of Huaihe River Basin （above Bengbu station） were taken as the research area. Based on the land use data from 1980 to 2020, the PLUS model was used to simulate and predict the land use types in the study area from 2030 to 2100 under the scenarios of SSP1-2.6, SSP2-4.5, SSP5-8.5, and the continuation of land use status. The carbon module in the InVEST model was used to simulate and predict the carbon storage from 1980 to 2020 and the carbon storage from 2030 to 2100 under various scenarios, and the spatial and temporal changes of carbon storage in the middle and upper reaches of the Huaihe River Basin were compared and analyzed. The results showed that： ① From 1980 to 2020, the basin showed a decrease in both cultivated land and grassland,and the area of forest,water, construction, and unused land all increased, among which the area of cultivated land continued to decrease, with a total decrease of 4 699 km 2 in 40 a. Construction land continued to increase, with a total increase of 4 592 km 2 in 40 a. ② The carbon storage in the basin showed a downward trend, with a total reduction of 1.05×10 7 t from 1980 to 2020. ③ In the four scenarios, the area of each land type had different degrees of change, and that of the SSP1-2.6 scenario was relatively small out of the four scenarios. ④ Compared with the carbon storage in 2020, the carbon storage in the SSP1-2.6 scenario increased by 8.7×10 4 t, the carbon storage in the SSP2-4.5 scenario decreased by 1.42×10 7 t, the carbon storage in the SSP5-8.5 scenario decreased by 1.34×10 7 t, and the carbon storage in the current continuation scenario decreased by 1.22×10 7 t. The study can provide a scientific basis for land use structure management and ecological protection in the middle and upper reaches of the Huaihe River Basin （above Bengbu station） in the future.

Under the background of "dual carbon", the impact of the implementation of the Grain for Green project on the carbon storage of the ecosystem in the Yellow River Basin must be explored, which can serve as an important reference for improving the policy implementation of the new round of the Grain for Green project and improving the carbon sink capacity of the ecosystem in the Yellow River Basin. In this study, 1990, before the implementation of the project, was selected as the starting year of the research period, and 2020, after the implementation of the two rounds of the project, was selected as the end year of the research period. Based on the ecosystem type data from 1990 to 2020, the InVEST model was used to calculate the soil carbon pool, underground carbon pool, below carbon pool, dead organic matter carbon pool, and total carbon storage of ecosystems in the Yellow River Basin and the area where the project was implemented from 1990 to 2020. The results showed that： ① From 1990 to 2020, the area of forest ecosystem in the Yellow River Basin expanded by 26 610.06 km 2 , and the area of farmland decreased by 46 849.06 km 2 after the implementation of two rounds of the project. Spatially, the upper reaches of the Yellow River were dominated by grassland and other ecosystems； the middle reaches of the Yellow River were dominated by farmland, forest, and grassland ecosystems； and the lower reaches of the Yellow River were dominated by farmland ecosystems. ② From 1990 to 2020, the carbon storage in the project implementation area showed a fluctuating and increasing trend, and the total carbon storage reached a peak （219.47×10 8 t） in 2009 and decreased to 218.59×10 8 t in 2020 due to the decrease of grassland ecosystem from 2010 to 2020. Spatially, the high-value areas of carbon storage were distributed in Aba Tibetan and Qiang Autonomous Prefecture of Sichuan Province and the southern tip of Gansu Province in the upper reaches of the forest and grass accumulation and in the whole of Shanxi Province and the central and southern parts of Shaanxi Province in the middle reaches. Shangluo City in Shaanxi Province and Alxa League in Inner Mongolia Autonomous Region were prefecture-level cities with the highest and lowest average carbon density. ③ In 2035, the carbon storage loss of the natural development scenario was predicted to be 0.83×10 8 t, and the other three scenarios would increase this loss. Under the moderate farmland return scenario, the Yellow River Basin ecosystem had the strongest carbon sequestration capacity, and the predicted carbon storage would increase by 2.72×10 8 t compared with that in 2020, and the deep farmland return scenario was the comprehensive optimal scenario. Therefore, in the future, the Yellow River Basin could refer to the deep farmland return scenario to optimize and adjust the implementation plan of the Grain for Green project, and the predicted value of carbon storage can provide some data support for achieving the dual carbon goal.

The key pathogenesis of atherosclerosis(AS) in traditional Chinese medicine(TCM) lies in the combination of phlegm and stasis due to spleen deficiency. In Western medicine, it is believed that pyroptosis can lead to atherosclerosis, and endoplasmic reticulum stress has been shown to promote pyroptosis. According to the theories of " spleen in correlation with endoplasmic reticulum",guided by spleen governing transportation and transformation, and endoplasmic reticulum processing proteins, it is believed that the syndrome of phlegm combined with stasis due to spleen deficiency has similarities with the mechanism of macrophage pyroptosis induced by endoplasmic reticulum stress in accelerating the progression of AS. This study explored the correlation between phlegm combined with stasis due to spleen deficiency and pyroptosis induced by endoplasmic reticulum stress, and then analyzed the modern medical mechanisms of phlegm combined with stasis due to spleen deficiency in mediating atherosclerosis. The discussion enriches the theory of spleen in correlation with endoplasmic reticulum, provides research ideas on the prevention and treatment of AS by invigorating spleen,eliminating phlegm, and resolving stasis, and lays a theoretical foundation for the clinical application of spleen-invigorating TCM in the treatment of AS.

With the rapid urbanization and industrialization, heavy metal contamination in urban soil and surface dust has received particular attention due to its negative effects on the eco-environment and human health. Contamination and spatio-temporal characteristics, contamination sources, and source apportionment methods, as well as the ecological and health risks of heavy metals in urban soil and surface dust were reviewed. The knowledge gaps in current research and prospects of future works were proposed. Four key points were presented, including improving the research on the interaction mechanism of heavy metals in urban soil and surface dust under complex conditions, enriching verification methods to improve the source apportionment reliability of anthropogenic metals by receptor models, strengthening the research on chemical forms of heavy metals from different sources and their short-term accumulation processes in surface dust, and raising the credibility of ecological and health risk forecast of heavy metals by integrating the improved exposure parameters and chemical forms.

The quality control of Chinese medicinal decoction pieces is one of the key tasks in the traditional Chinese medicine industry. In this study, multi-source information fusion was employed to fuse the data from near-infrared spectroscopy, electronic tongues, and other tests and establish an overall quality consistency evaluation method for Atractylodis Macrocephalae Rhizoma, which provided methodological support for the overall quality evaluation of Atractylodis Macrocephalae Rhizoma. The near-infrared spectroscopy information was measured in both static and dynamic states for 23 batches of Atractylodis Macrocephalae Rhizoma samples from different sources, and the electronic tongue sensory information, moisture content, and leachate content were measured. The overall quality of Atractylodis Macrocephalae Rhizoma was evaluated by multi-source information fusion. The results showed that the near-infrared spectroscopy information of 16122103, 801000509, 801000352, 701003656, HX21L01, and 160956 was different from that of other batches of Atractylodis Macrocephalae Rhizoma powder in the static state, and 701003298, 16122103, 701003656, 701003107, 801000229, and 18090404 were the different batches in the dynamic state. The moisture content showed no significant difference between batches. The leachate content in the batch 801000509 was different from that in other batches. The electronic tongue sensory information of 150721004, 151237, 160703004, HX21M01, HX21K04, HX21K01, and 601003516 was different from that of other batches. Furthermore, data layer fusion was employed to analyze the overall quality of Atractylodis Macrocephalae Rhizoma. Four batches, 150721004, HX21M01, HX21K04, and HX21K01, showed the parameters exceeding the 95% control limits and differed from the other samples in terms of the overall quality. This study integrated the information of moisture, near-infrared spectroscopy, and other sources to evaluate the quality consistency among 23 batches of Atractylodis Macrocephalae Rhizoma samples, which provides a reference for the quality consistency evaluation of Chinese medicinal decoction pieces.

Objective: To explore relationship between intramuscular fat content of quadriceps femoris and clinical severity of knee osteoarthritis (KOA)., Methods: Totally 30 KOA patients were selected from February 2021 to June 2021, including 6 males and 24 females, aged with an average of (64.20±9.19) years old, and body mass index (BMI) was (24.92±3.35) kg·m-2. Patients were divided into relative severe leg (RSL) and relative moderate leg (RML) according to severity of pain on visual analogue scale(VAS). Musculoskeletal ultrasound was used to collect muscle images of quadriceps muscles on both sides of the patient, and Image J was used to analyze echo intensity (EI) of each muscle. Both VAS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to assess pain and function. Quadriceps muscle EI on both sides of patients was compared. Pearson correlation analysis was conducted to analyze correlation between quadriceps muscle EI value between RSL and RML, and linear regression was used to analyze relationship between each muscle EI and VAS and WOMA scores of patients., Results: The EI of RSL lateral vastus lateralis (VL) was 123.78±36.25 and RSL vastus medialis (VM) was 109.46±30.36 which were significantly higher than those of 108.03±31.34 and 93.32±26.04 of RML ( P <0.05), but there was no statistical significance in EI values of rectus femoris (RF) on both sides ( P >0.05). EI values of VL and VM on both sides were significantly correlated ( P <0.05). There was a significant positive correlation between VM EI value and VAS score in RSL and RML ( P <0.05). VM EI values in RSL were positively correlated with total WOMAC ( P <0.05), and VM VL EI values in RML were positively correlated with total WOMAC score ( P <0.05)., Conclusion: Intramuscular fat content of quadriceps is closely related to severity of clinical symptoms in KOA patients, and the most obvious one is VM. Therefore, the intramuscular fat content of quadriceps may be an objective indicator to evaluate severity of KOA patients. At the same time, reducing intramuscular fat content of the quadriceps muscle of KOA patients may be a new direction for the prevention and treatment of KOA.

To evaluate the ecological risk of heavy metals in the soil-crop system in the superimposed high background and human activities from pyrite mining, the heavy metal contents and chemical speciation in soil and crop samples were analyzed, and these data were used to assess the potential ecological risk and factors affecting the migration ability of heavy metals using bioconcentration factors(BCF), potential ecological risk index(RI), risk assessment code(RAC), and correlation analysis. The results indicate that the average Cd, Cu, Pb, and Zn concentrations exceeded the background values of soils in Zhejiang Province and China. Cd had the greatest potential ecological harm, followed by that of Hg. The bioactive components and potential bioactive components of Cd accounted for 46% and 33%, respectively, indicating relatively high bioavailability. Cu and Pb were mainly in potential bioactive components accounting for 60% and 73%, respectively. The As, Cr, Hg, Ni, and Zn were predominantly residual and accounted for >60%, which indicated low biological activity. The RAC levels were in the following order:Cd>Zn>Cu>Pb>Ni>As>Cr>Hg; soil Cd had the highest ecological risk, mainly with high and extremely high levels, whereas other elements had no risk or low risk. Compared with Cd content in soil, only eight rice samples had Cd contents exceeding the safety limit, and sweet potato samples did not exceed the standard. The migration and enrichment capability of rice in order from strong to weak was s follows:Cd>Zn>Cu>Hg>As>Ni>Cr>Pb; the bioactive component of Cd played a significant role in promoting Cd absorption by rice. Soil OM had a bi-directional effect on Cd bioavailability, whereas soil texture had an indirect effect. This comprehensive study shows that the total amount of heavy metals in soil, chemical speciation, biological activities, absorption, and enrichment of heavy metals by crops should be taken into consideration when assessing the ecological risks in the superimposed areas affected by high background and human activities, such as the pyrite mining area.

Objectives: To observe the effect of Yiyuan moxibustion on urodynamics and the expressions of transient receptor potential vanilloid 4 (TRPV4), adenosine triphosphate (ATP), tyrosine protein kinase KIT (C-Kit) and adenosine triphosphate receptor P2X5 in bladder tissue of rats with detrusor reflex-free neurogenic bladder (NB) after sacral cord injury (SCI), so as to explore its mechanism in promoting the recovery of urination function of NB rats., Methods: Female SD rats were randomly divided into sham operation, model, Yiyuan moxibustion, Yiyuan moxibustion+inhibitor (combination) and inhibitor groups, with 12 rats in each group. The model of detruser reflex-free NB after sacral SCI was established by modified Hassan Shaker spinal cord transection method. The behavioral score of Basso Beasttie Bresnahan (BBB) and urodynamic indexes were used to evaluate the model of rats after operation. Fifteen days after modeling, Yiyuan moxibustion was applied to "Shenque" (CV8) and "Guanyuan" (CV4) for 20 min, once daily for 14 days. Rats of the inhibitor and combination groups were given intravesical instillation of HC067047 (1 mL, 1 μmol/L, 30 min). After the interventions, urodynamics was used to evaluate the bladder function of rats. HE staining was used to observe the morphology of bladder tissue. ATP content in bladder tissue was detected by colorimetric method. The positive expression rates of C-Kit and their receptor P2X5 in bladder tissue were observed by immunofluorescence double labeling method, and TRPV4, C-Kit, and P2X5 protein expression levels in bladder tissue were detected by Western blot., Results: Compared with the sham operation group, the maximum bladder capacity and bladder compliance of rats in the model group were increased ( P <0.01), the leak point pressure, ATP content, the possitive expression rates of C-Kit and P2X5, and the protein expression levels of TRPV4, C-Kit, P2X5 in bladder tissue were decreased ( P <0.01). In comparison with the model and combination groups, the Yiyuan moxibustion group showed a decrease in maximum bladder capacity and bladder compliance ( P <0.01), an increase in leakage point pressure, ATP content, the possitive expression rates of C-Kit and P2X5, and TRPV4, C-Kit, and P2X5 protein expression levels ( P <0.01, P <0.05)；However, these indicators showed opposite trends in the inhibitor group ( P <0.01, P <0.05)., Conclusions: Yiyuan moxibustion can improve the urodynamics and bladder function in rats with bladder detrusor nonreflective after SCI, which may be related to its effect in activating the TRPV4 channel in bladder tissue, promoting the release of ATP from bladder epithelium, thus increasing the expression of bladder Cajal interstitial cells and their purinergic P2X5 receptors.

Objective: To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test. Methods: This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t -test, Mann-Whitney U test, and χ (2) test. A kappa test was used to compare the consistency between groups. Results: After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion: The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

Objective: To compare the clinical efficacy between electroacupuncture(EA) and moxibustion for neurogenic bladder (NB) after spinal cord injury (SCI)., Methods: One hundred and twenty patients with NB after SCI were randomly divided into an EA group, a moxibustion group, and an intermittent catheterization group, with 40 patients in each group. The patients in the intermittent catheterization group were treated with routine treatment and intermittent catheterization, while the patients in the EA group and the moxibustion group were treated with additional treatments of EA (discontinuous wave, with a frequency of 1.3-1.6 Hz, and intensity based on patient tolerance) and moxibustion, respectively. The acupoints used in both groups were Zhongji (CV 3) and Guanyuan (CV 4), bilateral Zusanli (ST 36), Yinlingquan (SP 9), and Baliao points. Each session lasted for 30 min, once daily, six times a week, for a total of six weeks.The maximum bladder capacity (MBC), residual urine vdume (RUV), detrusor pressure (Pdet) during the filling phase, bladder compliance (BC), maximum renal pelvis separation width of both kidneys, urine white blood cell count, TCM syndrome score, and World Health Organization quality of life assessment-BREF (WHOQOL-BREF) score were compared before and after treatment in the 3 groups. The number of patients in each group who achieved bladder functional balance was recorded, and the clinical efficacy was assessed after treatment., Results: After treatment, the MBC, Pdet, BC, and WHOQOL-BREF scores in the EA group and the moxibustion group were increased ( P <0.05), while the RUV, maximum renal pelvis separation width of both kidneys, urine white blood cell count, and TCM syndrome scores were decreased ( P <0.05, P <0.01). In the intermittent catheterization group, MBC, RUV, maximum renal pelvis separation width of both kidneys, and urine white blood cell count were decreased ( P <0.05), while BC and WHOQOL-BREF score were increased ( P <0.05) after treatment. After treatment, the MBC, Pdet, BC, and WHOQOL-BREF scores in the EA group and the moxibustion group were higher than those in the intermittent catheterization group ( P <0.05), while the RUV and TCM syndrome scores were lower than those in the intermittent catheterization group ( P <0.05). Moreover, after treatment, the MBC and Pdet in the moxibustion group were higher than those in the EA group ( P <0.05), while the RUV, maximum renal pelvis separation width of both kidneys, and TCM syndrome score in the EA group were lower than those in the moxibustion group ( P <0.05). The number of patients who achieved bladder functional balance after treatment in the EA group and the moxibustion group was higher than that in the intermittent catheterization group ( P <0.05). The cured and effective rate was 85.0% (34/40) in the EA group and 82.5% (33/40) in the moxibustion group, which were both higher than 65.0% (26/40) in the intermittent catheterization group ( P <0.05), there was no significant difference between the EA group and the moxibustion group ( P >0.05)., Conclusion: EA and moxibustion could effectively improve the functional state of bladder in patients with NB after SCI. EA is more effective in reducing residual urine volume and excessive activity of the urethral sphincter, and relieving TCM syndromes, while moxibustion is more effective in increasing the pressure of the detrusor during the filling period and establishing the detrusor reflex.

Objective: To investigate the effect of Liraglutide on platelet distribution width(PDW) and carotid intima-media thickness(cIMT) in type 2 diabetic mellitus patients with obesity. Methods: Randomized controlled trial. A total of 80 type 2 diabetes mellitus (T2DM) obese patients with unsatisfactory glucose control were prospectively enrolled in this study from the Department of Endocrinology of Yuhuangding Hospital Affiliated to Qingdao University from January to December 2021. All the participants were treated with metformin or sulfonylureas. They were randomly divided into two groups: Liraglutide treatment group (Li group, n =40) and Control group (Con group, n =40).The Li group started the treatment with Liraglutide on the basis of the original hypoglycemic agents and the Con group was treated with metformin and sulfonylurea. After 16 weeks of treatment, the changes of PDW, cIMT and body mass index (BMI) in the two groups were observed, multiple linear regression was uesd to analyze the influencing factors of cIMT variation, and the effect of liraglutide on PDW and cIMT in obese patients with type 2 diabetes was analyzed. Results: Finally, 38 patients completed the study in Li group, including 23 males and 15 females, aged 30-69(56±11) years. All 40 patients in Con group completed the study, including 18 males and 22 females, aged 39-67(59±7) years. After 16 weeks of treatment, the levels of PDW and cIMT in Li group were (12.8±1.6) fl and (0.85±0.08) mm, respectively, lower than those before treatment (15.0±1.6) fl and (1.14±0.10) mm ( t =18.61 and 20.37, respectively, both P <0.001); The PDW and cIMT in Con group were (13.6±1.5) fl and (1.05±0.10) mm, respectively, lower than those before treatment (15.0±1.5) fl and (1.13±0.13) mm ( t =17.42 and 9.65, respectively, both P <0.001). The levels of fasting plasma glucose (FPG) and total cholesterol (TC) in both groups were lower than those before treatment(all P <0.001). After the treatment, the levels of PDW, cIMT, FPG and TC in Li group were lower than those in Con group (all P <0.05). The changes of PDW and cIMT before and after the treatment in Li group were (2.2±0.7) fl and (0.30±0.09) mm, respectively, higher than those in the Con group [(1.4±0.5) fl and (0.09±0.06) mm], with a statistically significant difference (both P <0.001). The changes of FPG and TC in Li group were significantly higher than those in Con group (all P <0.05). Multiple linear regression analysis showed that liraglutide, the changes of TC and systolic blood pressure (SBP) were the influencing factors for the changes of cIMT [β (95% CI ) were 0.20 (0.17-0.23), 0.03 (0.01-0.06), 0.01 (0.00-0.01), respectively, all P <0.05] Conclusion: Liraglutide treatment could reduce PDW and cIMT, thus contributing to cardiovascular benefits.

The tumor microenvironment (TME), the environment of tumorigenesis and tumor progression, incorporates multiple types of cells and non-cellular components. TME plays an important role in tumorigenesis and tumor progression. Due to the abnormal proliferation of tumors, the TME has a unique chemophysiology environment and complex metabolic patterns, which subsequently affects the role of immune cells. Understanding the metabolic patterns of TME can help us develop immunotherapy regimens that target TME. Microbial metabolism and lipid metabolism, the key metabolic processes of TME, have emerged as important foci of research. The metabolites released by the microbiome and the reprogramming of cellular lipid metabolism affect the subsistence of tumor and immune cells. In this review, we summarized the composition and metabolic characteristics of TME and discussed the latest research progress in microbial metabolism and lipid metabolism in TME. We also provided an update on relevant metabolic regulatory targets and immunotherapy strategies, stressing that identifying highly effective therapeutic targets, in spite of the apparent difficulty, is what future research should be focused on., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To screen the prognostic biomarkers of metabolic genes in patients with multiple myeloma (MM), and construct a prognostic model of metabolic genes., Methods: The histological database related to MM patients was searched. Data from MM patients and healthy controls with complete clinical information were selected for analysis.The second generation sequencing data and clinical information of bone marrow tissue of MM patients and healthy controls were collected from human protein atlas (HPA) and multiple myeloma research foundation (MMRF) databases. The gene set of metabolism-related pathways was extracted from Molecular Signatures Database (MSigDB) by Perl language. The biomarkers related to MM metabolism were screened by difference analysis, univariate Cox risk regression analysis and LASSO regression analysis, and the risk prognostic model and Nomogram were constructed. Risk curve and survival curve were used to verify the grouping effect of the model. Gene set enrichment analysis (GSEA) was used to study the difference of biological pathway enrichment between high risk group and low risk group. Multivariate Cox risk regression analysis was used to verify the independent prognostic ability of risk score., Results: A total of 8 mRNAs which were significantly related to the survival and prognosis of MM patients were obtained ( P <0.01). As molecular markers, MM patients could be divided into high-risk group and low-risk group. Survival curve and risk curve showed that the overall survival time of patients in the low-risk group was significantly better than that in the high risk group ( P <0.001). GSEA results showed that signal pathways related to basic metabolism, cell differentiation and cell cycle were significantly enriched in the high-risk group, while ribosome and N polysaccharide biosynthesis signaling pathway were more enriched in the low-risk group. Multivariate Cox regression analysis showed that the risk score composed of the eight metabolism-related genes could be used as an independent risk factor for the prognosis of MM patients, and receiver operating characteristic curve (ROC) showed that the molecular signatures of metabolism-related genes had the best predictive effect., Conclusion: Metabolism-related pathways play an important role in the pathogenesis and prognosis of patients with MM. The clinical significance of the risk assessment model for patients with MM constructed based on eight metabolism-related core genes needs to be confirmed by further clinical studies.

Objective: To explore clinical effect of Scarf osteotomy combined with soft tissue balance in treating severe hallux valgus., Methods: Totally 38 patients(50 feet) with severe hallux valux who underwent Scarf osteotomy combined with soft tissue balance surgery from June 2019 to June 2021 were retrospectively analyzed, aged from 29 to 64 years old with an average of(54.7±6.8) years old; 26 feet on the left side and 24 feet on the right side;the courses of disease ranged from 5 to 23 years with an average of (12.4±3.9) years. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were compared before and after operation, and postoperative complications was observed. American orthopedic foot ankle society(AOFAS) score before operation and final follow-up was used to evaluate recovery of forefoot function, and visual analogue scale (VAS) was used to evaluate pain relief., Results: Thirty-eight patients (50 feet) were followed up from 15 to 23 months with an average of (18.3±3.2) months. Preoperative HVA, IMA and DMAA were (44.61±3.92)°, (18.74±2.51)°, (12.85±2.11)°, and improved to (13.45±2.13)°, (7.83±1.36)°, (7.03±1.39)°at final follow-up, which had statistical differneces( P <0.05). No delayed union or nonunion of osteotomy end, fracture or loosening of internal fixation, hallux varus occurred. VAS and AOFAS score improved from (6.81±2.14), (43.6±8.4)points before operation to (1.97±0.78), (87.6±5.2) points at final follow-up, which had statistical difference( P <0.01). According to AOFAS at final follow-up, 20 feet got excellent result, 28 feet good and 2 feet moderate., Conclusion: Scarf osteotomy combined with soft tissue balance release for severe hallux valgus has good stability and corrective effect, but learning curve and postoperative complications should be paid attention.

Histone methylation is one of the key post-translational modifications that plays a critical role in various heart diseases, including diabetic cardiomyopathy. A great deal of evidence has shown that histone methylation is closely related to hyperglycemia, insulin resistance, lipid and advanced glycation end products deposition, inflammatory and oxidative stress, endoplasmic reticulum stress and cell apoptosis, and these pathological factors play an important role in the pathogenesis of diabetic cardiomyopathy. In order to provide a novel theoretical basis and potential targets for the treatment of diabetic cardiomyopathy from the perspective of epigenetics, this review discussed and elucidated the association between histone methylation and the pathogenesis of diabetic cardiomyopathy in details.

The paper introduces professor GAO Shu-zhong 's understanding on "seeking yin from yang needling method" and its clinical application on the basis of " qi street" and "four seas" theories. Through professor GAO's clinical practice for years, he integrates and extendes the theories of "seeking yin from yang ", " qi street" and "four seas" in Huangdi Neijing ( The Yellow Emperor ' s Inner Classic ). In this specific acupuncture method, in reference with the theories of " qi street" and "four seas", acupuncture is exerted on yang part of body, e.g. the back and lumber region to treat the diseases of yin parts, e.g. the chest and abdomen, which is differentiated as yin-yang imbalance in pathogenesis. In order to fully explain the clinical curative effect of "seeking yin from yang needling method", the common diseases in clinic, e.g. the disorders of heart, spleen and stomach systems, as well as the gynecology are taken as examples in the paper.

Objective: To investigate the effect of celastrol on the proliferation and apoptosis of human multiple myeloma (MM) cell lines, reveal the relationship between IRAK4/ERK/p38 signaling pathway and celastrol regulating the proliferation and apoptosis of H929 and ARP-1 cells, and explore whether celastrol combined with bortezomib has synergistic effect., Methods: CCK-8 method was used to detect the viability of MM cell lines H929 and ARP-1 treated by different concentrations of celastrol, bortezomib, and their combination, and the synergistic effect was determined by Kim's formula. The apoptosis rate of H929 cells and necrosis rate of ARP-1 were detected by Annexin V/PI method. The expression of key proteins and apoptosis proteins in IRAK4/ERK/p38 signaling pathway were detected by Western blot., Results: Celastrol could significantly inhibit the proliferation of H929 and ARP-1 cells (r=0.9018, r=0.9244) and induce apoptosis in a time-dependent manner. Compared with the control group, celastrol could significantly up-regulate the expression of PARP and cleaved caspase-3 while down-regulate the expression of p-IRAK4, p-ERK, and p-p38 in H929 and ARP-1 cells. Celastrol and bortezomib alone inhibited the proliferation of H929 and ARP-1 cells. Compared with celastrol and bortezomib alone, their combination had lower cell survival rate and higher apoptosis rate (P<0.05)., Conclusion: Celastrol can inhibit the proliferation and promote the apoptosis of H929 and ARP-1 cells, which may be related to inhibiting the phosphorylation of IRAK4 and blocking the activation of IRAK4/ERK/p38 signaling pathway. Celastrol combined with bortezomib has synergistic effect, which can more effectively inhibit the proliferation and induce apoptosis of H929 and ARP-1 cells.

In order to ascertain the impact of pyrite mining on the surrounding farmland soil environment and human health, 42 surface soil samples (from 0-20 cm) were collected around the pyrite mining area in Longyou county. In this study, the concentrations of eight heavy metals (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) and the pH in the topsoil were analyzed, and the concentration characteristics of heavy metals, source analysis, and human health risks assessment were studied using statistical analysis (SA), geo-accumulation index ( I geo ), positive matrix factorization (PMF), and the health risk model. The average of ω (Cd), ω (Cu), ω (Pb), and ω (Zn) concentrations exceeded the background values of soils in Zhejiang province and China. According to the agricultural land pollution risk screening values (GB 15618-2018), Cd, Cu, Pb, and Zn were up to 82%, 49%, 42%, and 31%, respectively. The I geo shows that the major pollutant element in the soils was Cd, followed by Cu, Pb, and Zn. The PMF analysis indicates that nature sources (As, Cr, and Ni), comprehensive pollution sources caused by high geological background and mining of ore-forming geological bodies (Cd, Cu, Pb, and Zn), and anthropogenic sources (Hg) were the three major sources of heavy metals in the study area, with contributions of 32%, 46%, and 22%, respectively. The results of the health risk assessment indicate that the major non-carcinogenic factor triggering risks was the ingestion of Pb; Cr exposure had carcinogenic risk for adults, and Cr and As exposure had carcinogenic risk for children.

Drug instructions,the statutory and technical documents recording effectiveness and safety information,are an important basis for guiding doctors,pharmacists,and patients to use drugs rationally,and their scientificity,standardization,and accuracy directly affect the medication safety of the public. The sections of adverse drug events,contraindications,precautions,warnings,and application for specific populations in drug instructions directly express safety information and measures for rational use of drugs. In the drug life cycle,marketing authorization holders( MAHs) need to update safety information in the instructions promptly to ensure the safety and effectiveness of clinical drug medication. At present,revising instructions is an important measure to control drug risks. In the drug life cycle,in order to standardize the revision of safety information in the instructions by MAHs and eliminate inexact terms such as &quot; unclear&quot;,the Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions,a series of group standards,have been established under the guidance of Standardization Department,China Association of Chinese Medicine. Therefore,on the basis of the existing rules and regulations,the standardized technical procedures for revising instructions came into being to help clinical safe and rational medication of drugs,and implement the strategy of &quot; Healthy China&quot;.

Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions,a series of group standards,were proposed by Professor ZHANG Bing from Research Center for Pharmacovigilance and Rational Use of Traditional Chinese Medicine,and underwent centralized management by Chinese Association of Chinese Medicine. They were officially released on July 23 and implemented on July 31,2021. The series of group standards consist of six sections,including general principles,adverse drug events,contraindications,precautions,application for special populations,and warnings. The section of general principles is comprised of holistic and programmatic expressions,which explain the general technical requirements for revising the marketed Chinese patent medicine instructions. The other five sections focus on information collection,screening,transformation,and illustration of specific items,forming a standardized revision technical process. This series of standards is the result of multiple rounds of research and the suggestions of more than 200 experts in different professional fields of &quot; medicine-pharmacy-management-law-enterprise&quot; have been gathered therein to reach a consensus. With the purposes of establishing standardized technical specifications for the revision of safety information in the marketed Chinese patent medicine instructions,guiding marketing authorization holders in revising the instructions,filling the gaps in the research of Chinese patent medicine instructions,promoting the deve-lopment of pharmaceutical care and academic research,and encouraging the rational and safe medication of Chinese patent medicine,the series of group standards is of great significance.

The ripe dried fruit of citron(Citrus medica) is one of the important sources of Chinese herb Citri Fructus. At the same time, it is also grown for edible and ornamental uses. There are many species and abundant genetic variation. To clarify the intraspecific variation and resource distribution of citron, this study investigated the variation in 11 citron fruits, basically covering the main species in China, including Xiaoguo citron(C. medica var. ethrog), Goucheng(C. medica var. yunnanensis), Muli citron(C.medica var. muliensis), Dehong citron(C.medica×Citrus spp.), Fuzhou citron(C.medica×C.grandis?), Mawu(C.medica×C.grandis?), Cangyuan citron, Binchuan citron, Sweet citron, Big citron, and Small citron. The natural communities of citron were proved to be mainly distributed in the southwestern and western Yunnan and southeastern Tibet of China, with Yunnan, Sichuan, Guangxi, Chongqing, Hubei, and Zhejiang identified as the main production areas. Citron has also been widely grown in India, the Mediterranean region, and the Caribbean coast countries. The field investigation revealed the large-scale intraspecific variation of citron fruits. Most of the fruits are oval-like or sphere-like in shape. The fruits are green when raw and yellow when ripe, with oil cell dots on the skin, stripe-likes running from top to bottom, and bulge at the top. Usually, in the smaller citron fruits, the pulp and juice vesicles are better developed and the central columella is tighter. By contrast, the juice vesicles and central columella in larger fruits became more vacant, with carpels visible, and the apex segregation and development of the carpels is one of the reasons for variation. These variations should be given top priority in the future variety selection and breeding, and the quality differences of different citron species and their mechanisms should be further studied. In particular, variety selection and classification management according to their medicinal or edible purposes will provide scientific and technological supports for the orderly, safe, and effective production of citron products consumed as food and medicine.

In order to solve the problems of confusion in clinical medication and imperfect instructions in Chinese patent medicines(CPMs), the Standardization Department of the China Association of Chinese Medicine and Center for Pharmacovigilance and Rational use of Chinese Medicine in Beijing University of Chinese Medicine jointly compiled the Instructions for Clinical Application of Chinese Patent Medicines(CPMs). As the interpretation and supplement of drug instruction information, it aims to guide clinical safety and rational use of CPMs. In addition, the technical specification for clinical application description of CPMs has been formulated, which covers the seven processes of &quot;carding instructions, clinical investigation, data retrieval, data screening, evidence classification, path transformation and writing format&quot;. It will enable readers of Instructions for Clinical Application of Chinese Patent Medicines to understand the work behind the compilation.

To observe the effect of Xinfeng Capsules on rheumatoid arthritis (RA) B lymphocytes,inflammatory mediators,FAK/CAPN/PI3K pathway,in order to explore the mechanism of Xinfeng Capsules in improving clinical symptoms of RA.Joint and systemic symptoms of RA patients were observed,and laboratory indicators[hemoglobin (HGB),platelet count (PLT),erythrocyte sedimentation (ESR),immunoglobulin (Ig) G,Ig A,Ig M,rheumatoid factor (RF),anti-cyclic citrulline antibody (CCP-AB),C-reactive protein (CRP)]were detected.ELISA was used to detect serum interleukin (IL)-1β，IL-10,IL-33,chemokine 5 (CCL5),and vascular endothelial growth factor (VEGF).CD3~-CD19~+B cells were measured by flow cytometry.Western blot was used to detect FAK,p-FAK,CAPN,PI3K protein.The results showed that Xinfeng Capsules could significantly alleviate RA joint and systemic symptoms and improve clinical efficacy.And Xinfeng Capsules could increase HGB,decrease PLT,CCP-AB,CRP,ESR index,upregulate IL-10 expression,and down-regulate IL-1β，IL-33,CCL5,VEGF,CD3~-CD19~+B cells,FAK,p-FAK,CAPN,PI3K expressions (P&lt;0.01).Based on the above results,Xinfeng Capsules may reduce the expression of CD3~-CD19~+,regulate the balance of inflammatory cytokines and chemokines,inhibit abnormal activation of FAK/CAPN/PI3K pathway,and improve clinical symptoms of RA.

Objective: To study the efficacy and safety of lactase additive in improving lactose intolerance in preterm infants., Methods: A total of 60 preterm infants with lactose intolerance who were admitted to the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2019 were randomly divided into a lactase treatment group and a control group, with 30 infants in each group. The infants in the lactase treatment group were given 4 drops of lactase additive (180 mg) added into preterm formula or breast milk, and those in the control group were given placebo, oral administration of probiotics (live combined Bifidobacterium , Lactobacillus and Enterococcus powder) at half an hour after feeding (1 g each time, twice a day), and clockwise abdominal massage around the belly button at 1 hour after feeding for 15 minutes each time, 3 times a day. Fecal pH, fecal reducing sugar, growth indicators, symptoms of lactose intolerance, and laboratory markers were measured at the end of the first and second weeks after intervention., Results: Finally 29 infants in the lactase treatment group and 26 infants in the control group completed the trial. At the end of the first week after intervention, compared with the control group, the lactase treatment group had significantly lower frequency of daily milk vomiting and gastric retention amount ( P < 0.05) and a significantly higher proportion of infants with fecal pH > 5.0 ( P < 0.05). At the end of the second week after intervention, compared with the control group, the lactase treatment group had significantly lower frequency of daily milk vomiting and 24-hour abdominal circumference difference ( P < 0.05) and a significantly higher proportion of infants with the absence of gastric retention, fecal pH > 5.0, or negative reducing sugar in feces ( P < 0.05). No adverse reactions associated with the lactase additive or probiotics were observed during the trial., Conclusions: Lactase additive can safely and effectively improve the clinical symptoms caused by lactose intolerance in preterm infants.

In this paper,metabolomics and network pharmacology were used to investigate the bioactive components of Harrisonia perforata and their possible mechanisms of action. Metabolites in the flowers,fruits,branches,leaves and stalks of H. perforata were analyzed by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry. Meanwhile,multiple statistical analysis methods including principal component analysis( PCA) and orthogonal partial least squares discriminant analysis( OPLS-DA)were applied to screen and identify differential compounds. With metabolomics method,9 differential compounds were preliminarily identified from leaves and other non-traditional medicinal parts. Subsequently,these compounds were explored by using network pharmacology. With gastrointestinal absorption and drug-likeness as limiting conditions,they were imported into the Swiss ADME,from which 7 compounds with potential medicinal activity were obtained. Then,their targets were predicted by PharmMapper,with Human Protein Targets Only and Normalized Fit Score&gt;0. 9 set as limiting conditions,and 60 standardized potential targets were identified with Uniprot. KEGG( Kyoto encyclopedia of genes and genomes) pathway data was obtained using metascape and the &quot; potential active ingredients-target-pathway&quot; network was constructed with Cytoscape 3. 7. 2. The enrichment analysis of KEGG demonstrated that the 60 targets were enriched in 78 signaling pathways( min overlap: 3,P value cutoff: 0. 01,min enrichment: 1. 5),many of which are related to anti-bacteria,anti-inflammation and anti-virus,such as IL-17 signaling pathway,RIG-I-like receptor signaling pathway and NOD-like receptor signaling pathway. Finally,depending on the clinical activity of H. perforata,the relevant signaling pathways were analyzed through experimental data and literature. Dehydroconiferyl alcohol was reported to have the anti-inflammatory effect and perforamone D to possess the antimycobacterial activity. The KEGG pathway enrichment analysis showed that dehydroconiferyl alcohol could act on the Alzheimer&apos;s disease( AD) signaling pathway by targeting CDK5 R1 and BACE1. ACh E inhibitor is the most promising drug to treat AD,while dehydroconiferyl alcohol has been proved to inhibit ACh E according to literature. The experimental results revealed that the extract of leaves of H. perforata can effectively inhibit the growth of Staphylococcus aureus. These are consistent with the enrichment analysis results of KEGG. This study explored the bioactive components and pharmacodynamics of the leaves of the H. perforata,laying a theoretical foundation for its in-depth development and rational application.

Objective: To analyze and predict the effect of coronavirus infection on hematopoietic system and potential intervention drugs, and explore their significance for coronavirus disease 2019 (COVID-19)., Methods: The gene expression omnibus (GEO) database was used to screen the whole genome expression data related with coronavirus infection. The R language package was used for differential expression analysis and KEGG/GO enrichment analysis. The core genes were screened by PPI network analysis using STRING online analysis website. Then the self-developed apparent precision therapy prediction platform (EpiMed) was used to analyze diseases, drugs and related target genes., Results: A database in accordance with the criteria was found, which was derived from SARS coronavirus. A total of 3606 differential genes were screened, including 2148 expression up-regulated genes and 1458 expression down-regulated genes. GO enrichment mainly related with viral infection, hematopoietic regulation, cell chemotaxis, platelet granule content secretion, immune activation, acute inflammation, etc. KEGG enrichment mainly related with hematopoietic function, coagulation cascade reaction, acute inflammation, immune reaction, etc. Ten core genes such as PTPRC, ICAM1, TIMP1, CXCR5, IL-1B, MYC, CR2, FSTL1, SOX1 and COL3A1 were screened by protein interaction network analysis. Ten drugs with potential intervention effects, including glucocorticoid, TNF-α inhibitor, salvia miltiorrhiza, sirolimus, licorice, red peony, famciclovir, cyclosporine A, houttuynia cordata, fluvastatin, etc. were screened by EpiMed plotform., Conclusion: SARS coronavirus infection can affect the hematopoietic system by changing the expression of a series of genes. The potential intervention drugs screened on these grounds are of useful reference significance for the basic and clinical research of COVID-19.

Professor SHAO Ming-xi 's experience in treatment of arthralgia in breast cancer is summarized. Professor SHAO believes that the dysfunction of liver, spleen and kidney is the primary and the invasion of the exogenous wind, cold and damp is the secondary in arthralgia in breast cancer. Emphasized on syndrome/pattern differentiation, this disorder is identified as 4 patterns, i.e. liver qi stagnation, blockage by phlegm and stasis, qi and blood deficiency and obstruction by wind, cold and damp. Acupuncture-moxibustion is applied to Hegu (LI 4), Taichong (LR 3) and Waiguan (TE 5). The supplementary acupoints are selected on the base of syndrome/pattern differentiation. Tuina is combined with acupuncture-moxibustion and the reinforcing and reducing techniques are used appropriately. Shaoyang meridian is specially considered, due to which, Waiguan (TE 5) and Zhongzhu (TE 3) of triple energizer meridian of hand- shaoyang and Yanglingquan (GB 34) and Zulinqi (GB 41) of gallbladder meridian of foot- shaoyang are combined. Additionally, it stresses the combination of the local and distal acupoints and the coordination of various therapies of TCM to achieve the better effect.

Paddy soil often undergoes frequent dry-wet alternation. The change in water status not only affects the physical and chemical properties of the soil, but also changes the structure and diversity of the soil microbial communities, which in turn determines the rate of soil organic carbon mineralization. However, the effects of different water conditions and soil microbial biomass levels on the process of soil organic carbon mineralization and its mechanisms are still unclear. Therefore, this study took typical subtropical paddy soil as the research object, applied a laboratory incubation experiment with two water treatments of dry-wet and continuous flooding, and reduced the soil microbial biomass through chloroform fumigation, thereby obtaining high and low soil microbial biomass carbon contents, to elucidate the influencing mechanisms of microbial biomass and water conditions on organic carbon mineralization in paddy soil. The results showed that during the first 30 d of incubation, the dry-wet treatment was in a non-flooded stage and its cumulative CO 2 emissions were significantly lower than those of the continuous flooded treatment. After 30 d, the dry-wet treatment entered the flooded stage. The difference in the cumulative CO 2 emissions of the soils with a high microbial biomass carbon content between the dry-wet and continuous flooding treatments gradually decreased, and there was no significant difference on day 78. In the soil with a low microbial biomass carbon content, the cumulative CO 2 emissions of the dry-wet treatment on day 78 was still significantly lower than that of the continuous flooded treatment. The soils with a low microbial biomass carbon content showed a faster CO 2 emission rate at the beginning of the incubation period (first 20 d), which was 1.1-6.1 times greater than that of the high microbial biomass carbon soils owing to their high soil dissolved organic carbon (DOC) content, and the CO 2 emission rate then gradually decreased until it was below that of the soil with a high microbial biomass carbon content. The soil organic carbon mineralization rate became stable later in the incubation period (days 45-78). The stable mineralization rate of the high microbial biomass carbon soil was 20%-30% higher than that of the low microbial biomass carbon soil. The multiple regression analysis results showed that the decrease in the soil DOC content (ΔDOC) and the increase in the Fe 2+ content (ΔFe 2+ ) significantly affected the change in cumulative CO 2 emissions (ΔCO 2 ) under continuous flooding conditions, but had no effect on ΔCO 2 during the flooding stage of the dry-wet treatment. The correlation analysis showed that the daily CO 2 emission rate of soils with high microbial biomass carbon was significantly positively correlated with glucosidase activity under dry-wet treatment and significantly negatively correlated with acetylglucosaminidase (NAG) and peroxidase activities under continuous flooding treatment. In the low microbial biomass carbon soils, the daily CO 2 emission rate of the continuous flooding treatment was negatively correlated with the NAG activity, but showed no correlation with enzyme activities under dry-wet management. In summary, the cumulative CO 2 emissions of dry-wet treatment were lower than those of continuous flooding treatment, and the difference was significant in soils with low microbial biomass carbon. The size of the soil microbial biomass determined the level of the stable soil organic carbon mineralization rate. The amount of soluble organic carbon and iron reduction affected the soil CO 2 emissions under continuous flooding conditions, and the soil water conditions affected the daily CO 2 emission rate and its key influencing enzymes. This study provides data and theoretical support for the carbon cycle and carbon sequestration potential in paddy soil.

The effects of polyether sulfone (PES) microplastics and 2,4-dichlorophenol (2,4-DCP) on the loosely-bound extracellular polymeric substances (LB-EPS) and tightly-bound EPS (TB-EPS) of anaerobic granular sludge were investigated. In addition, high-throughput sequencing technology was used to analyze the changes in the microbial community and gene functions in the anaerobic granular sludge. The results revealed that the chemical oxygen demand (COD) removal rates of the 2,4-DCP and PES+2,4-DCP experimental groups were 35% and 37%, which were 57% and 55% lower than that of the blank control group, while the COD removal rates of the PES experimental group remained around 90%. After the addition of the PES microplastics and 2,4-DCP, the protein and polysaccharide contents in the LB-EPS decreased compared with the control group, and the polysaccharide content in TB-EPS increased the least. In presence of the PES microplastics and 2,4-DCP, the activity of coenzyme F 420 was inhibited. Through high-throughput sequencing, the microbial richness and diversity of the anaerobic granular sludge in the experimental group were reduced with the addition of the PES microplastics or 2,4-DCP. In the control group and the experimental group, the dominant bacteria at the phylum level were Proteobacteria (13.45%-44.47%), Firmicutes (6.86%-21.67%), and Actinobacteria (3.16%-18.11%). The abundance of β -Proteobacteria in the PES+2,4-DCP experimental group was reduced by 15.28%, while the abundance of γ -Proteobacteria increased by 28.44% compared with the control group. Based on the phylogenetic investigation of the communities using the reconstruction of unobserved states (PICRUSt) analysis, it was found that in the experimental group with the PES microplastics or 2,4-DCP, the genes related to the sludge energy metabolism function were 0.25%-0.72% more than the control group; therefore, the abundance of genes related to the transport function group decreased significantly.

Objective: To observe the changes of serum metabolites in patients with multiple myeloma (MM) by metabonomics, and explore the potential biomarkers for diagnosis, prognosis, and progression of MM., Methods: Serum samples were collected from 26 patients with MM and 50 healthy controls. The data detected by liquid chromatography-mass spectrometry (LC-MS) was input into SIMCA-14.0 software for multivariate statistical analysis. Principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), and orthogonal partial least squares discriminant analysis (OPLS-DA) were used to analyze the changes of metabolites., Results: The metabolic change of uric acid and trans-vaccenic acid in serum samples of MM patients was 9.39 times and 2.77 times of these in healthy people, respectively, which were significantly higher than those of healthy people, and the difference was statistically significant(P<0.01)., Conclusion: Uric acid and trans-vaccenic acid are expected to be important metabolic indicators for the diagnosis, prognosis, and efficacy evaluation of MM, thus providing some clues for the pathogenesis of MM.

The incidence of gastric cancer is the highest among all kinds of malignant tumors in China. Because gastric cancer is very hard to identify in its early stage, the early diagnosis rate of gastric cancer in China is relatively low. At present, the pathological diagnosis of gastric cancer mainly depends on the diagnosis of pathologists. However, the gradual improvement of people's living standards and the growing demand for medical and health care have exacerbated the shortage of medical resources, which has become a even more serious problem. Therefore, there is an urgent need for new technologies to help deal with this challenge. In recent years, with the rapid development of artificial intelligence (AI) and digital pathology, AI-aided pathological diagnosis based on convolutional neural network (CNN) as the core technology is showing promises for improving the diagnostic efficiency of gastric cancer. It is also of great significance for the early diagnosis and treatment of the disease and the reduction of its high incidence and mortality. We herein summarize the application and progress of deep-learning CNN in pathological diagnosis of gastric cancer, as well as the existing problems and prospects of future development., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Four antibiotics[azithromycin (AZM), sulfamethoxazole (SMZ), ciprofloxacin (CIP), and tetracycline (TCY)], and the antibiotic resistance genes (ARGs)[sulfonamides ( sul1 and sul2 ), tetracyclines ( tetX and tetM ), quinolones ( qnrS and qnrD ), macrolides ( ermB ), and 16S rDNA] were selected as target compounds. Artificial ecosystems were constructed with combinations of two emergent plants and Microcystis aeruginosa ( Acorus calamus + Cordyceps , algae+ Cordyceps , algae+ Acorus calamus , and algae+ Acorus calamus + Cordyceps ) in an indoor-simulated river system. Throughout the artificial ecosystems, changes in antibiotic concentrations and other pollution indicators (i.e., COD, NH 4 + -N, TP, and TN) were monitored in different media (the aqueous phase, sediment phase, and in plants), and the distribution and removal of ARGs in aqueous and sediment phases were explored. Removal of the target compounds was calculated based on mass balance, and the correlation between ARG abundance and environmental factors in the aqueous and sediment phases was analyzed. The results showed that the constructed artificial ecosystem achieved removal rates of COD, NH 4 + -N, TP, and TN ranging from 60.2% to 74.8%, 63.4% to 77.4%, 64.0% to 73.2%, and 46.8% to 54.8%, respectively. The antibiotics in the aqueous phase were notably removed and the artificial ecosystem 'algae+ Acorus calamus + Cordyceps ' achieved the best removal efficiency for the four antibiotics. Removal rates of the antibiotics in the sediment phase were ranked in the order TCY>CIP>AZM>SMZ; the removal efficiency of TCY in the 'algae+ Acorus calamus + Cordyceps ' system reached up to 53.5%. The total removal rates of antibiotics obtained by the ecosystems were ranked in the following order:algae+ Acorus calamus + Cordyceps > algae+ Cordyceps > algae+ Acorus calamus > Acorus calamus + Cordyceps . Removal of the four ARGs was very efficient and was higher in the aqueous phase than in the sediment phase. Correlations between the ARGs, the other pollution indicators, and the antibiotics were variable; tetX and environmental factors were correlated in the aqueous phase, while AZM and its corresponding ARGs were not significantly correlated in the sediment phase. The results showed that ARGs can be targeted under corresponding antibiotic pressure and other types of environmental pressure. In the study system, the concentrations of antibiotics did not directly affect the transmission of ARGs. Overall, this study shows that artificial ecosystems constructed with emergent plants and Microcystis aeruginosa can be effective at purifying water and reducing the environmental risks of antibiotics in urban rivers.

Groundwater is an important water source in the central Guohe River basin but pollution and water quality deterioration present a significant challenge. Here, 80 groups of groundwater samples were collected between June and September 2019 including 61 groups of shallow groundwater samples, 9 groups of middle groundwater samples, and 10 groups of deep groundwater samples. The hydrochemical characteristics and formation mechanisms of groundwater at these different depths were analyzed using statiatical techniques, Piper triangular diagrams, Gibbs figures, and ion ratios. The following results were noted:① Groundwater is weakly alkaline overall, and the dominant anion and cation at different depths were HCO 3 - and Na + . The shallow and deep groundwater mainly consist of fresh water while the middle groundwater is mainly brackish water. The hydrochemical typology of the shallow groundwater was mainly HCO 3 -Ca·Mg and HCO 3 -Na·Mg. HCO 3 ·SO 4 ·Cl-Na was found to be the dominant hydrochemical typology in the middle and deep groundwater. ② The chemical composition of the groundwater shows notable vertical variations. With depth, the mean mass concentrations of TDS, Na + , Mg 2+ , Cl - , SO 4 2- , and HCO 3 - first increase and then decreasing, while the mean mass concentration of Ca 2+ gradually decreases. These vertical differences are closely related to the sedimentary environment of the aquifer and the intensity of water-rock interaction. ③ The formation of groundwater hydrochemical characteristics is influenced by water-rock interactions, cation exchange, and human activities, with water-rock interaction dominated by sodium silicate dissolution. Human activities generally have the greatest impact on the shallow groundwater. ④ The water quality of the deep groundwater is notably better than that of the shallow and middle groundwater. However, excessive exploitation of the deep groundwater resource has led to the formation of a regional groundwater funnel, enhancing the difference in middle and deep groundwater levels. To reduce the risk of ground subsidence and the contamination of the deep water with middle brackish water, deep groundwater exploitation wells should be carefully positioned and regulated.

The nationwide Se-enriched threshold plays a key role in identifying China's selenium-enriched land resources and developing characteristic agricultural practices. In this study, we used the cooperative data of 10222 sets of crops and roots in China for the past 10 years with a systematic analysis of the selenium content characteristics of the soil and the status of selenium-enriched agricultural products. The preliminary estimates of the selenium-enriched threshold based on a bulk crop-soil linear model and population selenium-intake are presented. Finally, a collaborative analysis model of soil selenium-enrichment rate and crop selenium-enrichment rate is established, coming up with the nationwide Se-enriched threshold:total selenium ≥ 0.40 μg·g -1 in paddy soil, and total selenium ≥ 0.30 μg·g -1 in dryland soil. The threshold passed the feasibility test in 13 provinces, providing strong support for the China Geological Survey to formulate and promulgate this technical standard for the delimitation of the natural selenium-enriched land.

We conducted a pot experiment to investigate the effects of planting broadleaf tree species (i.e., Cinnamomum camphora , Schima superba , and Quercus glauca ) and Moso bamboo ( Phyllostachys edulis ) on soil carbon mineralization and microbial community structure. The rates of soil carbon mineralization were measured via alkali trapping method. The structural and functional diversity of soil bacterial and fungal communities were analyzed by terminal restriction fragment length polymorphism (T-RFLP) and real-time quantitative PCR techniques. The soil planted with Moso bamboo exhibited a significantly higher carbon mineralization rate and labile carbon content than those in the soils planted with broadleaf tree species. The underground biomass of Moso bamboo was higher than that of broadleaf tree species. The soil bacterial communities were more sensitive than fungal communities to the planting of different plant species . Moreover, soil fungal diversity of Moso bamboo was distinctly different from that of broadleaf tree species. Compared to the diversity of soil bacterial communities, the diversity of soil fungal communities was more closely related with soil pH, organic carbon content, and carbon mineralization. In comparison to the broadleaf tree species, the Moso bamboo planting could substantially increase soil organic carbon minera-lization, which was affected mainly by the soil fungal community structure.

In ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair has the effect in protecting damaged neurons, but its mechanism has not been clear. In this study, network pharmacology was used to predict the mechanism of Rehmanniae Radix Praeparata-Corni Fructus in the treatment of ischemic stroke sequela. Through database search and literature retrie-val, 40 active ingredients of Rehmanniae Radix Praeparata and Corni Fructus were obtained, and their targets were obtained through STITCH and TCMSP databases. The targets of ischemic stroke sequela were obtained through OMIM,GAD,TTD and DrugBank databases. By screening the intersections of active ingredients targets and stroke treatment targets, 21 potential targets were obtained. The DAVID database was used for GO enrichment analysis and KEGG pathway analysis of potential targets. GO enrichment analysis showed that Rehmanniae Radix Praeparata-Corni Fructus were mainly involved in regulation of blood pressure, negative regulation of extrinsic apoptotic signaling and positive regulation of angiogenesis. KEGG pathway analysis showed that Rehmanniae Radix Praeparata-Corni Fructus could inhibit inflammatory response and apoptosis signaling pathway by regulating HIF-VEGFA signaling pathway in neural stem cell proliferation, TNF signaling pathway and NF-kappaB signaling pathway. Molecular docking technique was used to verify that Rehmanniae Radix Praeparata-Corni Fructus component has a good binding activity with potential targets. The results showed that in ischemic stroke sequela phase, Rehmanniae Radix Praeparata-Corni Fructus drug pair could play an important role in recovering neural function, promoting the proliferation of neural stem cells, angiogenesis, preventing neural cells apoptosis and regulating inflammatory factors.

The distribution characteristics of exogenous carbon (C) in the C fractions of biocrusts-covered soil are critical for understanding the geochemical cycling of C with biocrusts in drylands. A 13 C pulse labeling experiment was conducted for moss-dominated biocrusts-covered soil and bare soil on the Loess Plateau of China with semiarid climate, with the content of 13 C in different C fractions being continuously measured to determine the biocrust effects on the distribution of exogenous C in each C fraction. Our results showed that, 1) the 13 C abundance of each C fraction in the biocrusts-covered soil was steadily changed with time, due to the relatively low rate of nutrient cycling in the biocrusts-covered soil and also to the relatively low biomass of moss in the biocrusts-covered soil as compared with vascular plants. 2) The 13 C content of each C fraction in the biocrusts-covered soil was significantly higher than that in the bare soil. Specifically, the 13 C content of total organic C (TOC), microbial biomass C (MBC), and dissolved organic C (DOC) in the biocrusts-covered soil was 0.258, 0.078, and 0.004 mg·kg -1 , respectively, which was 3.1, 18.5, and 2.6 times higher than that in the bare soil. Moreover, the 13 C content in the moss of the biocrusts-covered soil was 1.45 mg·kg -1 . 3) The presence of biocrusts changed the distribution characteristics of each C fraction, with the newly assimilated C being mainly distributed in active organic C and biological components of the biocrusts-covered soil. In the biocrusts-covered soil, the 13 C distribution in MBC (30.6%) was higher than that in DOC (1.7%), and the 13 C distribution in the C of moss was 20.3%. 4) The transferred amount and storage capacity of MB 13 C in the biocrusts-covered soil were 15.7 and 19.5 times of that in the bare soil, respectively. The turnover rate of MB 13 C in the biocrusts-covered soil and bare soil was 2.94 and 3.30 times per month, respectively, implying that the turnover time of MB 13 C in the biocrusts-covered soil was 1.1 times longer than that in the bare soil. In conclusion, biocrusts could greatly change the distribution characteristics of each C fraction and increase C turnover rate, highlighting its important roles in C cycling in dryland ecosystems.

Cadmium pollution poses a threat to human health. The examination of spatial distribution of Cd in soils can be used to assess the risks posed to humans and the environment. The enrichment characteristics and variation rules of heavy metal cadmium in the soil were revealed by analyzing the concentration and fractions of Cd in the soil at different depths in the sea-land interaction zone. The results showed that: ① the concentration of Cd in the surface water of Nansha was lower than 0.0001 mg ·L -1 , and the physical and chemical properties of river sediments showed spatial differences with the boundary of "Shang Heng-li River". Cd was mainly deposited in the north of the "Shang Heng-li River", with the mean total Cd of 2.71 mg ·kg -1 . The total Cd in the sediment of the "Shang Heng-li River" and the rivers south of it were 0.062-0.39 mg ·kg -1 , which caused minimal harm to the marine environment. ② The content of Cd in the soil profile gradually decreased with an increase in soil burial depth. The median content of Cd in the five layers, including 0-20 cm, 20-50 cm, 50-90 cm, 90-140 cm, and 140-200 cm, were 0.51, 0.50, 0.45, 0.42, and 0.33 mg ·kg -1 , respectively, and the dispersion degree gradually decreased with an increase in buried depth; the vertical migration amount and migration depth of Cd increased significantly in soils with pH less than 5. ③ The residual Cd in the soil accounted for approximately 40%, and the trend was typically flat with a change in buried depth. The median proportion of acid soluble Cd was consistent with the change in pH and increased with an increase in the buried depth of the profile, while the median proportion of reducible Cd was consistent with the change in iron and manganese content, and decreased with an increase in buried depth of section. These results have important guiding significance for the regional prevention and control of Cd pollution in farmland surrounding cities and the treatment and remediation of polluted soil.

Heavy metals (HMs) are naturally occurring elements that have high natural background levels in the environment. Therefore, it is important to conduct ecological risk assessment and identify potential sources of HMs. In the past, studies were conducted at the regional scale. The accuracy of those studies could not meet the needs of spatial planning and natural resource management. Therefore, it is necessary to conduct ecological risk assessment at the township scale. In this study, 1092 soil samples (from 0-20 cm depth) were collected in the town of Reshui, an area with high background levels of soil HMs with the parent material of carbonatite, which is commonly found in Southwest China. The town of Reshui is a multi-ecological risk superimposed area where the ecological risk is high. In this study, concentrations of HMs (Cd, Cr, As, Hg, Pb, Cu, Zn, and Ni) in the topsoil were analyzed, and statistical analysis (SA), geographic information system (GIS) modeling, and positive matrix factorization (PMF) analysis were performed. The geoaccumulation index ( I geo ) and potential ecological risk index (PERI) were applied for the ecological risk assessment and quantification of the sources of the soil HMs. The mean values of HM concentrations in the topsoil were 18.1, 1.18, 174.1, 202.2, 0.09, 71.1, 34.9, and 167.2 mg ·kg -1 for As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, respectively, which were considerably higher than the average background value (ABV) in soils in Yunnan Province except for As and Pb. The average concentrations of Cd, Cr, Cu, and Ni exceeded the screening values specified in the soil contamination risk in agricultural land (GB 15618-2018) by 5.82, 1.16, 4.04, and 1.02 times, respectively. The I geo value shows that the major pollutant is Cu in the surface soil of the study area, followed by Cr, and Cd. Speciation analysis of HMs indicates that HMs (Cr, As, Pb, Cu, Zn, and Ni) mainly exist in the residual form, mostly from the geological background with low bioavailability. The potential effective components of Hg have higher levels, but the total amount of Hg and its pollution risk are lower. Cd has a high bioavailability ratio, is easy to enter the soil solution and be absorbed by crops, and is the HM with the highest pollution risk in the study area. The PERI shows that the proportions of low ecological risk, moderate risk, and high risk soil samples are 44.23%, 54.40%, and 1.37% of the total number of samples, respectively. Hg and Cd were the major sources of risk because of their high toxicity coefficient. The PMF analysis indicates that there are four major sources of HMs in the study area: human activity, natural sources, coal mining and traffic emissions, and agricultural sources with the risk contribution ratios of 9.29%, 53.67%, 11.23%, and 25.81%, respectively. The PMF analysis effectively quantified the ecological risk from these sources, providing a reference for further pollution control and prevention measures.

Nitrogen (N) labeled with 15 N was evenly added into plots of moss-dominated biological soil crusts (BSCs) and bare soil on the Chinese Loess Plateau. After that, the surface BSCs and bare soil samples were continuously collected within 1-30 days. The 15 N content of each N fraction in soil, microorganisms, and mosses was measured for each sample. The effects of BSCs on soil N fate and cycling was determined through analyzing the differences in the distribution of 15 N fractions between the BSCs and bare soil. Our results showed that: 1) The 15 N content of total N (TN), microbial biomass N (MBN), and dissolved organic N (DON) in the BSCs was 2.9, 17.5, and 9.0 times higher than that in the bare soil, respectively. The 15 N content of moss plants in the BSCs was 4.73 mg kg -1 . 2) The residual rate of 15 N in the BSCs and bare soil was 13.0% and 3.3%, respectively, indicating that the N fixing and holding ability of BSCs was four times higher than that of bare soil. The percentage of each 15 N fraction in T 15 N in the BSCs was in the order of MBN (54.3%)&gt;moss plant N (22.5%)&gt;DON (6.2%), while that in the bare soil was in the order of MBN (11.5%)&gt;DON (2.6%). Over all, microorganisms and mosses in the BSCs had 65.3% higher capacity of N fixation as compared with the bare soil. 3) The transferred amount and storage capacity of MB 15 N in the BSCs were 17.2 and 20.5 times higher than that in the bare soil, respectively. Accordingly, the turnover rate of MB 15 N in the BSCs and bare soil was 5.8 and 7.2 times per month, respectively, with the turnover time of MB 15 N in the BSCs being 1.2 times longer than that in bare soil. In conclusion, BSCs fix and hold more N than bare soil and change the distribution of each N fraction, implying that BSCs play a critical role in N cycling in dryland ecosystems.

The availability of carbon (C), nitrogen (N), and other substrates in soil determines the growth and metabolism of microorganisms and affects the activity of extracellular enzymes. To study the activities of β -1,4-glucosidase (BG) and β -1,4- N -acetylglucosaminidase (NAG) in response to C and N availability, samples that underwent four treatments-non-fertilization (CK), chemical fertilizer (NPK), combination of organic manure and chemical fertilizer (OM), and mixture of straw and chemical fertilizer (ST)-were collected from long-term fertilization paddy soil and incubated for 0, 4, 8, and 12 months to obtain soil with different C and N availability gradients. The results showed that the dissolved organic carbon(DOC) content of OM and ST treatment samples was 2-3 times higher than that of CK and NPK treatment samples. With the increase of DOC and ammonium (NH 4 + -N) contents, the activities of BG and NAG and the contents of microbial biomass C (MBC) and N (MBN) showed no increase during incubation within each treatment. Fertilization treatments, incubation time, and their interaction are crucial factors varying the contents of DOC, NH 4 + -N, MBC, and MBN among different fertilization treatments ( P <0.01). There was a positive correlation between MBC/MBN and DOC/NH 4 + -N of OM treatment ( P <0.05) and a negative relationship between ln(BG)/ln(NAG) and DOC/NH 4 + -N of ST treatment ( P <0.01), indicating that the availability of substrates played a key role in the potential activity of extracellular enzymes in paddy soil, and the carbon-nitrogen ratio of microbial biomass was controlled by the C/N stoichiometry of substrates in soil. The results have a certain guiding significance for further study on the variation of extracellular enzyme activity in paddy soil, regulating the balance of carbon and nitrogen, and improving the fertility of paddy soil.

Because coronavirus disease 2019(COVID-19) is highly contagious and serious, it has posed a major threat to public health worldwide. The curative effects of integrated traditional Chinese medicine and Western medicine in the treatment of COVID-19 have been widely recognized and confirmed. However, medical workers shall pay attention to drug-induced heart injury in clinical application. Based on the guideline from the Diagnosis and Treatment Plans for COVID-19(trial seventh edition), taking the recommended drugs as examples, by Western medicine, traditional Chinese medicine, Chinese herbal injection and integrated traditional Chinese and Western medicine, the study analyzed the basic characteristics of recommended drugs for cardiac injury by means of literature review and bioinformatics methods, and summarized cardiac adverse reactions, toxicity mechanisms, combined pharmacotherapy, special population and drug monitoring, focusing on the clinical manifestations, toxic components, targets and regulatory mechanisms of drug-induced cardiac injury. The findings suggested being vigilant to drug-induced cardiac injury during the treatment of COVID-19, playing the advantages of clinical pharmacists and clinical Chinese pharmacists, improving the knowledge reserve of pharmacovigilance, strengthening the prescription review, medication notification and medication monitoring, promoting rational drug use and paying attention to special populations and high-risk groups. The study aims to provide suggestions and reference for pharmacovigilance and pharmaceutical care for front-line doctors and pharmacists against COVID-19, in order to avoid the occurrence of drug-induced heart injury for patients with COVID-19.

Urban soils are more easily subjected to modification, especially by contamination because of various human activities, and the environmental problems caused by urban soil pollution have become more prominent. To systematically investigate concentration characteristics, pollution levels, and exposure risks of 13 trace metals in urban soils of planning areas for 193 cities above the prefectural level, located in 31 provinces (autonomous regions and municipalities) of China, levels of pollution in urban soil were evaluated using the geoaccumulation index and integrated pollution index of trace metals, and health risks of residents exposed to urban soils were quantified using the health risk assessment method recommended by the US Environmental Protection Agency (USEPA). The results show that the median concentrations of As, Be, Cd, Co, Cr, Cu, Hg, Ni, Pb, Se, Tl, V, and Zn in topsoils of urban planning areas were 9.25, 2.14, 0.174, 12.4, 68.4, 28.2, 0.095, 27.7, 31.1, 0.29, 0.61, 82.7, and 82.2 mg·kg -1 , respectively. Compared with the corresponding urban soil background values, the concentrations of Cd, Hg, and Se changed significantly. The geoaccumulation index ( I geo ) values showed that Hg in urban soils of the planning area was the most severe pollutant, followed by Se and Cd, which caused pollution levels of uncontaminated to moderately contaminated levels, while other trace metals were uncontaminated. The Nemerow IPI (IPI N ) revealed that the soils in 22 urban planning areas were heavily polluted and 16 urban planning areas were moderately polluted; in addition, the most polluted city in China was Zhuzhou in the Hunan province. The results of health risk assessment indicate that the soils in the five urban planning areas-Chenzhou City, Huangshi City, Zhuzhou City, Xiangtan City, and Longyan City-posed potential non-carcinogenic risks to children, and the major factor triggering risks was ingestion of Pb. To understand the soil pollution status and distribution of contaminated land parcel, it is suggested to carry out detailed investigation in cities with integrated moderate to heavy pollution to establish the list of contaminated land parcel and implement pollution control and restoration.

To explore the etiology, pathogenesis, distribution of syndromes and the rule of medication of chronic atrophic gastritis(CAG) in Beijing-Tianjin-Hebei region based on the latent structure model. Chronic atrophic gastritis of 279 cases in Beijing-Tianjin-Hebei region were extracted from the established database of spleen and stomach diseases of famous veteran Chinese medicine experts. The latent structure models of symptoms and drugs of chronic atrophic gastritis were constructed by using Lantern 3.1.2 software, and the latent structure models were interpreted. SAS 10.0 software was used to mine association rules of drugs and symptoms. The constitutional characteristics of patients with chronic atrophic gastritis in Beijing-Tianjin-Hebei region were "turbid toxin and damaging Yin". The common syndromes were turbid toxin, deficiency of stomach Yin, stagnation of liver and stomach, stagnation of liver and stomach Qi, obstruction of stomach collaterals and blood stasis, and weakness of spleen and stomach. Common medicines are Lobeliae Chinensis Herba, Scutellariae Barbatae Herba, Amomi Fructus Rotundus, Amomi Fructus, Poria, Isatidis Radix, Artemisiae Scopariae Herba, Scorpio, Coptidis Rhizoma, Lilii Bulbus, Linderae Radix, Phragmitis Rhizoma, Ophiopogonis Radix, Pogostemonis Herba, Eupatorii Herba, Magnoliae Officinalis Cortex, Aurantii Fructus Immaturus. Common prescriptions are Baihe Wuyao Powder, Danggui Shaoyao Powder, Xiaoyao Pills, Xiangsu Powder, Dachengqi Decoction, Zuojin Pills, Qingzhong Decoction, Zhishi Daozhi Pills, etc. The application of latent structure model and correlation analysis in the empirical study of famous and veteran Chinese medicine experts is in line with the research direction of modern Chinese medicine "traditional Chinese medicine + X". The conclusions obtained effectively tap the experience of famous and veteran TCM experts, and provide a data and visual clinical reference and prescription compatibility for young TCM physicians in the treatment of chronic atrophic gastritis based on syndrome differentiation.

Rheumatoid arthritis(RA) has a high disability rate and is highly harmful. It has a long course of treatment and is prone to adverse reactions or events(ADR/ADE). Selection of drugs in particular shall give consideration to both benefits and risk. Tripterygium Glycosides Tablets(TGT) is one of the important drugs for the treatment of RA. It has a remarkable efficacy, but a strong toxicity, which is controversial in clinical use. The study was oriented to patients, and quantitatively evaluated the efficacy and risk of TGT in treatment of RA, providing an intuitive basis for clinical safety and effective application of TGT. A multi-criteria decision-making analysis(MCDA) model of TGT was built in the treatment of RA, and then benefit and risk indicators were weighted by SWING method. Totally 53 random clinical trials(RCT) in accordance with the evaluation criteria were included by Meta-analysis method. The RCT results were merged by Meta-analysis, indicating that compared with the conventional therapy of chemical immunosuppressant(CISD), TGT could improve the curative effect whether it was used alone or in combination with CISD, but it would increase the incidence of reproductive system damage. The combined administration with CISD would also increase the incidence of liver and kidney damages. Treatment outcomes varied according to the different conditions of the combined administration with CISD. Based on MCDA model and clinical results, the benefit value, risk value and benefit-risk value of different doses, courses and combined administration of TGT in the treatment with RA were compared. The results showed that when the benefit and risk of the drug were equally important to the patient, the benefit-risk value of the single administration of TGT was 59, while that of the combined administration of TGT and CISD was 39. Therefore, the benefit-risk value of the single administration of TGT was 100% better than the combined administration. When the combined administration of TGT and CISD is unavoidable, the benefit-risk value of low-dose TGT(0.10-0.99 mg·kg~(-1)·d~(-1)) was 48, while that of high-dose TGT was 36. Therefore, low-dose TGT combined with CISD was more easily accepted by patients. The 2 to 3-month treatment course had a benefit-risk value of 40, while the long treatment course had a benefit-risk value of 38. Based on existing evidences, the single administration of TGT may be better than the combined administration with CISD. If the patients need to combine with CISD to treat RA, low dosage and 2 to 3-month course may be relatively optimal.

Coumarin is an important class of natural organic compounds, which widely exists in a variety of plants and microorganisms. Coumarins have many biological activities and wide clinical applications, such as anti-tumor, anti-HIV, anti-bacterial, anti-inflammatory, anti-oxidation, anti-coagulation, but they have obvious toxic effects in rodents. It was found that the toxicity of coumarins in different animals and organs was significantly different, and high dose oral administration was more likely to produce toxic reactions. Based on the research and analysis of domestic and foreign literatures in recent 60 years, this paper mainly summarized the hepatotoxicity and pulmonary toxicity induced by coumarins, and probed into their possible mechanisms. It was found that the toxicity of coumarins had metabolic differences and species differences. The liver of rats and lungs of mice were more susceptible to coumarins. Toxic reactions occurred mainly in the second metabolic pathway of coumarin metabolism in vivo. In order to put forward safety considerations and evaluate the impact of coumarin on human body, it was found that coumarin is unlikely to produce hepatotoxicity at normal exposure level. It was also suggested that species differences due to different metabolic patterns in model animals should be carefully considered when assessing coumarin toxicity, in order to provide reference for clinical research and rational use of coumarins and improve the rational use of coumarins.

Objective: To observe the effect of acupoint application at bilateral "Tianshu" (ST25) on intestinal mobility and immunoactivity of vasoactive intestinal peptide (VIP) and substance P (SP) in colonic myenteric plexus of rats with functional constipation (FC), so as to analyze its mechanisms underlying improving FC., Methods: Forty male SD rats were randomly divided into 4 groups, namely normal control, model, acupoint application and medication, with 10 rats in each group. The FC model was established by gavage of Loperamide Hydrochloride suspension fluid (0.5 mg/mL, 3 mg·kg -1 ·d -1 ) for 7 days. Herbal medicine paste (composed of Rheum Officinale, Sodium Sulfate, Mangnolia Officinalis, etc.) was applied to bilateral ST25 for 6 h, once daily for 4 weeks. Rats of the medication group were treated by gavage of Mosapride suspension fluid (0.15 mg/mL, 1.58 mg·kg -1 ·d -1 ) for 4 weeks. After the treatment, the rats were deprived of water for 12 hours, and then treated by gavage of 2 mL of activated carbon suspension, followed by recording the first black defecation time and the number of fecal particles and water content of feces within 6 h so as to assess the intestinal mobility. The immunoactivity and average surface density of VIP and SP positive granules in the colonic myenteric plexus were detected by immunohistochemistry., Results: Compared with the normal control group, the first black defecation time was significantly prolonged, and the number and water content of fecal particles within 6 h, and the expression and the average surface density of VIP and SP were significantly reduced in the model group ( P < 0.01). After the treatment and compared with the model group, the first black defecation time was shortened, and the fecal water content and fecal particle number within 6 h, as well as the expression and the average surface density of VIP and SP were considerably increased in both acupoint application and medication groups ( P < 0.01). There were no significant differences between the acupoint application and medication groups in all the indexes mentioned above after the interventions ( P > 0.05)., Conclusion: Acupoint application may improve the intestinal motility in FC rats, which may be asso-ciated with its effects in up-regulating the immunoactivity of VIP and SP in colonic myenteric plexus of the large intestine.

Objective: To observe the efficacy of "Tongdu Tiaoshen" (dredging Governor Vessel and regula-ting mind,needling on the cognitive function of patients with sepsis associated encephalopathy (SAE)., Methods: A total of 64 patients with SAE were enrolled in the present study, and randomly and equally divided into a control group and a treatment group. Patients in the control group received conventional medicines and conventional needling treatment. The patients of the treatment group received conventional medicines and "Tongdu Tiaoshen" needling treatment. The treatment was conducted once daily for 10 days. The Montreal Cognitive Assessment (MoCA) scale was used to assess the therapeutic effect after the treatment. Serum interleukin-6 (IL-6) was detected by radioimmunoassay, serum C-reactive protein (CRP) was detected by immuno-scattering method, and arterial blood lactic acid (Lac) content was detected by blood gas analyzer., Results: The effective rate in the treatment group was obviously higher than that in the control group ( P < 0.01). After the treatment, the MoCA scores were considerably increased in both groups compared with their own pre-treatment ( P < 0.01), and the MoCA scores in the treatment group were obviously higher than those of the control group in the visual space and executive function, attention and computational power, language, abstraction and delayed recall dimensions ( P < 0.01). The contents of IL-6, CRP and Lac in both groups were significantly decreased after the treatment relevant to those of their own pre-treatment ( P < 0.01), and were obviously lower in the treatment group than those in the control group ( P < 0.01)., Conclusion: "Tongdu Tiaoshen" needling can significantly improve the cognitive function of SAE patients, which may be associated with its effect in reducing inflammatory reaction of sepsis.

Taking the Zeyao Materia Medica,Benjing Fengyuan,De Pei Materia Medica,Shiyi Materia Medica,Harmful Benefits of Materia Medica as representative works in Qing Dynasty,this paper extracts text information from four aspects: drug identification,drug use,drug prevention and detoxification,constructs a drug pharmacovigilance information table of Qing Dynasty herbal works,and summarizes the drug pharmacovigilance of Qing Dynasty. Thought,in the Qing Dynasty,there were many recordings of drug pharmacovigilance. In the aspect of drug awareness,the main representative was Shi Yi Materia Medica which added many new drugs and introduced more new uses of drugs. In addition,in the aspect of drug use and prevention,the main representatives were Zeyao Materia Medica,Benjing Fengyuan,De Pei Materia Medica,and Harmful Benefits of Materia Medica. In the aspect of taboo of disease and syndrome,attention should be paid to the integration of medicine so as to make drugs closely related to clinical use. Although there is no special introduction on detoxification,it has been introduced in various medicines in the De Pei Materia Medica,Shiyi Materia Medica,which has a relatively systematic and complete drug warning ideology system of " drug identification-use-drug prevention-detoxification".This study found that the traditional pharmacovigilance thought of Qing Dynasty had the characteristics of attaching importance to the clinical application of toxic traditional Chinese medicine and the combination of medicine,which had certain guiding significance for modern clinical medication. This paper aims to explore the traditional drug pharmacovigilance knowledge in representative works of the Qing Dynasty,analyze the characteristics of the drug pharmacovigilance thought in the Qing Dynasty,and lay a foundation for clarifying the traditional drug pharmacovigilance system.