Study on the mechanism of moxibustion for rheumatoid arthritis based on liquid chromatography-mass spectrometry / 针灸推拿医学（英文版）

Objective: To explore the mechanism of moxibustion for rheumatoid arthritis (RA) by observing the metabolite changes in urine using liquid chromatography-mass spectrometry (LC-MS)-based metabolomic analysis. Methods: Twenty-four rats were randomly divided into a control group, a model group, and a moxibustion group. Rats in the model and moxibustion groups were established as collagen-induced arthritis (CIA) models. The control and model groups did not receive any intervention; rats in the moxibustion group received moxibustion at Shenshu (BL23) and Zusanli (ST36). After three weeks of intervention, ankle joint, serum, and urine samples were collected for pathological examinations and metabolomic tests. Results: After moxibustion treatment, the CIA rats showed increased body mass, reduced swelling of the hind paws and arthritis score, decreased serum cytokine levels, and improved histopathological evaluation of the ankle joint. Twenty-four significantly altered metabolites were found, mainly involved in alanine metabolism, taurine and hypotaurine metabolism, tricarboxylic acid cycle, phenylalanine metabolism, tyrosine metabolism, and primary bile acid biosynthesis. These metabolites may serve as potential biomarkers for RA. Conclusion: Moxibustion can effectively resist inflammation in CIA rats. The potential biomarkers and the abnormal metabolic pathways of RA can be identified by LC-MS-based metabolomics. Metabolomics may be an effective way to explain the mechanism of moxibustion in treating RA.

Vascular complications caused by hyaluronic acid injection: a clinical analysis / 中华医学美学美容杂志

Objective:To analyze the epidemiological characteristics of vascular complications induced by hyaluronic acid facial injection.Methods:Patients with vascular complication induced by facial hyaluronic acid facial injection were collected in the Fourth Medical Center of the General Hospital of the Chinese People's Liberation Army from January 1, 2016 to October 1, 2021, including 5 males and 37 females. The age ranged from 16 to 70 (34±10) years. The clinical data, injection site, clinical symptoms and previous facial surgery history of the patients were analyzed and investigated.Results:Vascular complications occurred in 12 cases (28.6%). Nasolabial fold in 8 (19.0%) cases; Glabella in 6 (14.3%) cases; frontal part in 6 (14.3%) cases. There were 27 patients (64.3%) with a history of facial surgery. Furthermore, history of facial surgery had no effect on the clinical manifestations of vascular complications ( P>0.05). Among the 18 patients with visual impairment, 12 patients reported that the symptoms of ptosis, bulbar conjunctival congestion, and eye movement dysfunction had diminished after thrombolytic treatment, while 4 patients showed recovery to some extent in visual acuity. Likewise, 24 patients with blood circulation disorders were healed after treatment, with residual pigmentation and a slight scar left. Conclusions:Women aged 30 to 39 years old are the main target population of cosmetic surgery, as well as the most common population of vascular complications. Particular care should be taken in the nose, nasolabial fold, glabella and forehead areas of the operation. Patients with previous surgical history should be adequately informed before surgery, and postoperative observation time should be appropriately prolonged.

Preliminary evaluation of immune checkpoint inhibitors as a salvage treatment of tumor recurrence after liver transplantation for hepatocellular carcinoma / 中华器官移植杂志

Objective:To explore the safety and efficacy of immune checkpoint inhibitors(ICI)for patients with tumor recurrence after liver transplantation(LT).Methods:A single-center retrospective study was conducted for 6 recipients of tumor recurrence after LT on a therapy of ICI admitted into Shulan(Hang Zhou)Hospital from September 2015 to June 2018.The authors examined the occurrences of graft rejection and clinical outcomes of overall response rate, progression-free survival and overall survival after dosing of PD-1/PD-L1 inhibitors.Results:Six patients enrolled with tumor recurrence on a therapy of ICI undergoing LT due to hepatocellular carcinoma (HCC). Nivolumab (n=4) and duvalizumab (n=2) were administrated.The median session of treatment was 8.3(2-31) cycles.The disease outcomes were stable (3/6, 50%) and progressive (3/6, 50%), The progression-free survival time of 3 disease-controlled patients was 1.5, 16.2 and 18 months and the median survival time after recurrence was 19.75(10.8-37.8) months.Rejection occurred in 1 patients (1/6, 16.7%) and the occurring time of rejection was 28 days after PD-1 inhibitor dosing.After acute rejection, high-dose corticosteroids and immunoglobulin were ineffective and the patient died from acute rejection related liver failure.Conclusions:ICI may be employed as a salvage treatment for tumor recurrence after LT for HCC.Due to a possibility of severe acute rejection, usage should be cautious under close monitoring of liver function.

Survey of total radioactivity in drinking well water around Bayanwula uranium mine / 中华放射医学与防护杂志

Objective:To investigate the total radioactivity in drinking well water around the Bayanwula uranium mine.Methods:Totally 174 samples of drinking well water and 5 samples of filtered well water from residential houses were collected during dry and wet seasons in 2020 around the Bayanwula uranium mine. Total α and total β radioactivity in dry season and wet season were analyzed for detrmining whether there were differences between them and the relation between total radioactivity with different locations away from the uranium center. The radioactivity in filtered drinking well water used in residential houses was also investigated. Radioactivity were measured and analyzed using low background alpha and beta radioactivity meters, and the data were analysed using SPSS analytical statistical method.Results:In the drinking well water around Bayanwula uranium mine, the activity concentrations of total α and β measured in dry season were 0.024-2.468 Bq/L with a mean of (0.605±0.507) Bq/L and 0.125-1.395 Bq/L with a mean of (0.420±0.235) Bq/L, respectively. The values measured in wet season were 0.049-2.988 Bq/L with a mean of (0.825±0.605) Bq/L for total α and 0.059-1.623 Bq/L with a mean of (0.506±0.265) Bq/L for total β, respectively. The average value of total radioactivity in water samples was lower within 10, 30 and 20 km of the uranium mine in the descending order.Conclusions:The radioactivity in well water around the Bayanwula uranium mine is high, with the total α and β in samples greater in wet season than in the dry season and without elevated levels as compared to the pre-mining background.

Preliminary application experience of disk microfluidic chip for detecting CALR gene mutation in patients with cerebral infarction / 中华检验医学杂志

Objective:To establish a disk (CD) microfluidic chip detection platform for the rapid detection of CALR-1 and CALR-2 mutations in patients with cerebral infarction, and summarize its clinical application value.Methods:Based on microfluidic technology and loop mediated isothermal amplification technology, a CD microfluidic chip detection platform for simultaneous detection of CALR-1 and CALR-2 gene mutations were established, and the sensitivity, specificity, repeatability and accuracy of the platform were verified. A total of 124 patients with cerebral infarction treated in Huashan Hospital, Shanghai Medical College, Fudan University from November 2019 to March 2021 were prospectively selected into the experimental group; and 80 healthy subjects were included in the control group. The CALR-1 and CALR-2 gene mutations in anticoagulant peripheral blood samples were detected by the CD microfluidic chip. Each chip could detect 4 samples at the same time and synchronously detect 3 indexes of each sample. The detection results could be obtained after isothermal amplification for 40 min. At the same time, sequencing method was used to verify the test results, and the consistency of the results of the two detection methods was compared.Results:Using this CD microfluidic chip platform, the synchronous amplification of 3 indexes in the sample could be completed within 40 min without the need of thermal circulation, and the whole detection process of the sample could be completed within 60 min. For samples with a high concentration of target nucleic acid, typical positive signals could be visualized after amplification for 10 min, and the test results would be available within 30 minutes after receiving the samples. The detection sensitivity of CD microfluidic chip method for CALR-1 and CALR-2 mutation load concentration was 1.0% and 0.5% respectively. Nonspecific amplification was not observed for the non-target nucleic acid samples, indicating the high specificity of this method. The coincidence rates of intra and inter batch repeatability were 100% (20/20) respectively. Two samples with CALR gene mutation were found in the cerebral infarction group, both of which were CALR-1 mutations (L367fs*46). There was no CALR-1 or CALR-2 mutation in the control group. The detection results of CD microfluidic chip method were completely consistent with the sequencing verification results (100% [204/204]).Conclusions:The CD microfluidic chip method could be used for the detection of CALR-1 and CALR-2 gene mutations in clinical samples of patients with cerebral infarction. This method has the advantages of high detection sensitivity, good detection specificity, fast detection speed and high detection flux, which is helpful to clarify the etiology of patients with cerebral infarction.

Efficacy of infliximab in the treatment of small intestinal Crohn's disease and its effects on simple endoscopic score for Crohn's disease, routine blood test and nutritional indexes / 中国基层医药

Objective:To investigate the efficacy of infliximab in the treatment of small intestinal Crohn's disease and its effects on simple endoscopic score for Crohn's disease (SES-CD), routine blood test and nutritional indexes.Methods:Eighty-four patients with small intestinal Crohn's disease who received treatment in Zhejiang Xin'an International Hospital between November 2019 and March 2021 were included in this study. They were randomly divided into control and observation groups with 42 patients each. The control group was treated with azathioprine. The observation group was treated with azathioprine and infliximab. Clinical efficacy, SES-CD score, hemoglobin (Hb) level, white blood cell (WBC) count, platelet (PLT), albumin (ALB), pre-albumin (PA) and total protein (TP) levels pre- and post-treatment were compared between the two groups.Results:Response rate in the observation group was significantly higher than that in the control group [92.8% (39/42) vs. 73.8% (31/42), χ2 = 5.48, P < 0.05]. There was no significant difference in SES-CD score pre-treatment between the control and observation groups [(7.24 ± 1.30) points vs. (7.33 ± 1.27) points, t = -0.34, P > 0.05]. After treatment, SES-CD scores in the control and observation groups were (5.12 ± 1.17) points and (4.22 ± 0.98) points, respectively, which were significantly decreased compared with those before treatment ( t = 11.01, 14.66, both P < 0.001). After treatment, SES-CD score in the observation group was significantly lower than that in the control group ( t = 4.19, P < 0.001). Before treatment, there were no significant differences in Hb level [(110.23 ± 16.19) g/L vs. (112.27 ± 15.98) g/L], WBC count [(7.61 ± 2.54) × 10 9 g/L vs. (7.47 ± 2.61) × 10 9 g/L] and PLT level [(420.14 ± 130.27) × 10 9 g/L vs. (419.23 ± 131.15) × 10 9 g/L] between the control and observation groups ( t = -0.58, 0.25, 0.03, all P > 0.05). After treatment, Hb level [(120.25 ± 14.36) g/L and (130.17 ± 12.24) g/L ], WBC count [(6.01 ± 1.88)× 10 9 g/L, (5.13 ± 1.96) × 10 9 g/L) and PLT level [(321.79 ± 110.21) × 10 9 g/L, (267.25 ± 100.23) × 10 9 g/L] in the control and observation groups were significantly decreased compared with those before treatment ( tcontrol group = -4.70, 6.60, 8.02, tobservaton group = -7.91, 3.50, 4.99, all P < 0.05). Hb level post-treatment in the observation group was significantly higher than that in control group ( t = -3.41, P < 0.05) . WBC count and PLT level in the observation group were significantly lower than those in the control group ( t = 2.10, 2.37, both P < 0.05). Before treatment, there were no significant differences in ALB level [(33.14 ± 5.66) g/L vs. (32.98 ± 5.73) g/L], PA level [(220.17 ± 71.14) mg/L vs. (219.89 ± 70.26) mg/L], TP level [(61.23 ± 8.21) g/L vs. (60.95 ± 8.17) g/L] between control and observation groups ( t = 0.12, 0.01, 0.15, all P > 0.05). After treatment, ALB level [(38.29 ± 6.13) g/L, (44.23 ± 6.07) g/L], PA level [(281.14 ± 85.23) mg/L, (320.27 ± 82.01) mg/L], TP level [(67.23 ± 7.22) g/L, (73.28 ± 6.97) g/L] in the control and observation groups were significantly increased compared with those before treatment ( tcontrol group = -7.90, -4.30, -5.08, tobservation group = -13.76, -7.52, -11.45, all P < 0.05). After treatment, ALB, PA and TP levels in the observation group were significantly higher than those in the control group ( t = -4.46, -2.14, -3.89, all P < 0.05). Conclusion:Infliximab is highly effective on small intestinal Crohn's disease. It can effectively decrease SES-CD score, improve routine blood parameters and nutritional indexes, alleviate azathioprine-induced myelosuppression, and reduce gastrointestinal reactions.

Prognosis and influencing factors of liver transplantation for hepatocellular carcinoma using steatotic donor liver: a multicenter study / 中华消化外科杂志

Objective:To investigate the prognosis and influencing factors of liver transplantation (LT) for hepatocellular carcinoma (HCC) using steatotic donor liver.Methods:The retrospective cohort study was conducted. The clinicopathological data of 152 pairs of donors and the corresponding recipients undergoing LT for HCC in the two medical centers [89 pairs in Shulan (Hangzhou) Hospital and 63 pairs in the First Affiliated Hospital of Zhejiang University School of Medicine] from January 2015 to December 2019 were collected. Of 152 donors, there were 131 males and 21 females, aged (48±12)years, and there were 130 cases with liver mild steatosis and 22 cases with liver moderate steatosis. Of 152 recipients, there were 138 males and 14 females, aged (52±9)years. Observation indicators: (1) follow-up, overall survival and tumor recurrence free survival of recipients; (2) influencing factors for overall survival and tumor recurrence free survival of recipients; (3) construction and validation of nomogram prediction model for overall survival and tumor recurrence free survival of recipients. Follow-up was conducted using outpatient examination and telephone interview to detect survival and tumor recurrence of recipients up to December 2020. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( IQR). Count data were described as absolute numbers. The Kaplan-Meier method was used to calculate the survival time and draw survival curve, and the Log-Rank test was used for survival analysis. The COX regression model was used for univariate and multivariate analysis. The independent risk factors were brought into the R 3.6.2 software to construct nomogram prediction model and draw the receiver operating characteristic (ROC) curve. The accuracy and discrimination of the nomogram prediction model were evaluated using the area under curve (AUC) and the calibration curve. Results:(1) Follow-up, overall survival and tumor recurrence free survival of recipients. All the 152 recipients undergoing LT for HCC using steatotic donor liver were followed up for 45.8(27.6)months, with the overall survival time and tumor recurrence free survival time of 36.5(32.3)months and 30.4(34.6)months. The 1-year, 3-year overall survival rates and tumor recurrence free rates of the 152 recipients were 73.4%, 55.8% and 62.2%, 43.4%, respectively. (2) Influencing factors for overall survival and tumor recurrence free survival of recipients. Results of univariate analysis showed that the donor liver cold ischemia time (CIT), the donor liver warm ischemia time (WIT), graft-to-recipient weight ratio (GRWR), ABO compatibility, recipient body mass index (BMI), recipient tumor diameter, recipient tumor number, recipient tumor differentiation degree, recipient preoperative alpha fetoprotein (AFP) were related factors influencing the overall survival of recipients ( hazard ratio=6.26, 1.90, 2.47, 4.08, 0.55, 5.16, 3.62, 5.28, 2.65, 95% confidence interval as 3.01?13.03, 1.07?3.38, 1.36?4.49, 2.07?8.03, 0.31?0.98, 2.56?10.42, 1.95?6.72, 1.60?17.42, 1.48?5.01, P<0.05) and the donor liver CIT, GRWR, ABO compatibility, recipient tumor diameter, recipient tumor number, recipient tumor differentiation degree, recipient preoperative AFP were related factors influencing the tumor recurrence free survival of recipients ( hazard ratio=4.24, 2.53, 4.05, 3.39, 3.10, 5.19, 2.63, 95% confidence interval as 2.50?7.21, 1.54?4.17, 2.12?7.72, 2.04?5.62, 1.91?5.03, 2.04?13.18, 1.61?4.30, P<0.05). Results of multivariate analysis showed that donor liver CIT ≥8 hours, GRWR ≥2.5%, recipient tumor diameter ≥8 cm and recipient preoperative AFP ≥400 μg/L were independent risk factors influencing the overall survival of recipients ( hazard ratio=4.21, 2.58, 4.10, 2.27, 95% confidence interval as 1.98?8.96, 1.24?5.35, 1.35?12.43, 1.13?4.56, P<0.05) and donor liver CIT ≥8 hours, GRWR ≥2.5%, recipient tumor diameter ≥8 cm, recipient tumor number ≥3 and recipient preoperative AFP ≥400 μg/L were independent risk factors influencing the tumor recurrence free survival of recipients ( hazard ratio=3.37, 2.63, 2.42, 2.12, 2.22, 95% confidence interval as 1.70?6.67, 1.40?4.96, 1.04?5.66, 1.08?4.18, 1.26?3.90, P<0.05). (3) Construction and validation of nomogram prediction model for overall survival and tumor recurrence free survival of recipients. The donor live CIT, GRWR, recipient tumor diameter, recipient preoperative AFP were used to construct nomogram prediction model for overall survival of recipients and the donor liver CIT, GRWR, recipient tumor diameter, recipient tumor number, recipient preoperative AFP were used to construct nomogram prediction model for tumor recurrence free survival of recipients. The ROC curve showed that the AUC of the nomogram prediction model for overall survival of recipients was 0.84 (95% confidence interval as 0.76?0.92, P<0.05), with the optimal diagnostic value as 7.3 and the specificity and sensitivity as 87.6% and 70.0%. The AUC of the nomogram prediction model for tumor recurrence free survival of recipients was 0.79 (95% confidence interval as 0.71?0.87, P<0.05), with the optimal diagnostic value as 5.8 and the specificity and sensitivity as 97.4% and 52.5%. The calibration curve showed that the nomogram prediction model had good distinction for high risk recipients in overall survival and tumor recurrence free survival. Conclusion:Donor liver CIT ≥8 hours, GRWR ≥2.5%, recipient tumor diameter ≥8 cm and recipient preoperative AFP ≥400 μg/L are independent risk factors influencing the overall survival of recipients who underwent LT for HCC using steatotic donor liver and donor liver CIT ≥8 hours, GRWR ≥2.5%, recipient tumor diameter ≥8 cm, recipient tumor number ≥ 3 and recipient preoperative AFP ≥400 μg/L are independent risk factors influencing the tumor recurrence free survival of recipients.

Extended criteria donor reconditioning and functional improvement in the viewshed of machine perfusion plus / 中华消化外科杂志

Liver transplantation (LT) is one of the most effective treatments for end-stage liver diseases. The number of LT in China currently ranks as the second worldwide. Extended criteria donor (ECD) reconditioning and functional improvement is an important research direction at present in order to address the bottleneck of donor graft shortage. In the future, it is pivotal to explore the original breakthroughs in basic theories of stem cell fates regulation, organ restoration and tissue regeneration, and to conduct national-wide, multicenter clinical investigations on the basis of innovative platform of medical, engineering and information technology. Therefore, the authors summarize evidence-based medical proof, latest research achievements and clinical experi-ences with novel concept of "machine perfusion plus" to explore the most updated mode that inte-grates traditional machine perfusion with cutting edge technologies such as multi-omics, molecular biology, information technology, automation technology and nanoparticle targeted delivery tech-nology. This aims to achieve real-time, non-invasive, intelligent quality assessment and monitoring of donor graft, and finally to establish a new technology system of ECD reconditioning and functional improvement, which can safely and effectively expand the donor pool, decrease the risk of post-transplant complications, and improve the prognosis of recipients, thus promoting the higher quality development of LT in China.

Promising natural lysine specific demethylase 1 inhibitors for cancer treatment: advances and outlooks / 中国天然药物

Lysine specific demethylase 1 (LSD1), a transcriptional corepressor or coactivator that serves as a demethylase of histone 3 lysine 4 and 9, has become a potential therapeutic target for cancer therapy. LSD1 mediates many cellular signaling pathways and regulates cancer cell proliferation, invasion, migration, and differentiation. Recent research has focused on the exploration of its pharmacological inhibitors. Natural products are a major source of compounds with abundant scaffold diversity and structural complexity, which have made a major contribution to drug discovery, particularly anticancer agents. In this review, we briefly highlight recent advances in natural LSD1 inhibitors over the past decade. We present a comprehensive review on their discovery and identification process, natural plant sources, chemical structures, anticancer effects, and structure-activity relationships, and finally provide our perspective on the development of novel natural LSD1 inhibitors for cancer therapy.

Molecular cloning and characterization of three phenylalanine ammonia-lyase genes from Schisandra chinensis / 中国天然药物

Phenylalanine ammonia-lyase (PAL), which catalyzes the conversion from L-phenylalanine to trans-cinnamic acid, is a well-known key enzyme and a connecting step between primary and secondary metabolisms in the phenylpropanoid biosynthetic pathway of plants and microbes. Schisandra chinensis, a woody vine plant belonging to the family of Magnoliaceae, is a rich source of dibenzocyclooctadiene lignans exhibiting potent activity. However, the functional role of PAL in the biosynthesis of lignan is relatively limited, compared with those in lignin and flavonoids biosynthesis. Therefore, it is essential to clone and characterize the PAL genes from this valuable medicinal plant. In this study, molecular cloning and characterization of three PAL genes (ScPAL1-3) from S. chinensis was carried out. ScPALs were cloned using RACE PCR. The sequence analysis of the three ScPALs was carried out to give basic characteristics followed by docking analysis. In order to determine their catalytic activity, recombinant protein was obtained by heterologous expression in pCold-TF vector in Escherichia coli (BL21-DE3), followed by Ni-affinity purification. The catalytic product of the purified recombinant proteins was verified using RP-HPLC through comparing with standard compounds. The optimal temperature, pH value and effects of different metal ions were determined. Vmax, Kcat and Km values were determined under the optimal conditions. The expression of three ScPALs in different tissues was also determined. Our work provided essential information for the function of ScPALs.

Difficulties and advances of incisional hernia repair after hepatobiliary and pancreatic surgery / 中华消化外科杂志

Abdominal incisional hernia is caused by poor healing of myofascial layer of abdominal wall and abdominal visceral organs protruding through the defect after abdominal surgery. The incidence of abdominal incisional hernia is 5.0%?20.0%, even higher after hepato-biliary and pancreatic surgery. Although great progress has been made in the methods of abdominal incision closure, hernia repair technology and materials, the overall incidence, repair effect and prognosis of abdominal incisional hernia are still not significantly improved. The incisional hernias after hepatobiliary and pancreatic surgery are relatively more complex, and the difficult problems of surgical repair are more prominent, including effectively controlling basic diseases, choosing a better surgical method, reasonably using a variety of abdominal wall defect closure and reconstruction techniques, and reducing the risk of postoperative complications. Relevant guidelines for abdominal incisional hernia repair and abdominal closure have been issued and updated all over the world. In order to improve the treatment of incisional hernia after hepatobiliary and pancreatic surgery and improve the prognosis of patients, the authors summarize the difficulties and new progress in the repair of incisional hernia after hepatobiliary and pancreatic surgery.

Transplant oncology creates a new era of liver transplantation for the treatment of liver cancer / 临床肝胆病杂志

In recent years, the integration of surgery, oncology, immunology, pharmacology, and imaging has gradually formed the new discipline of transplant oncology. With the development of transplant oncology, liver transplantation plays an increasingly important role in the treatment of hepatobiliary and pancreatic malignant tumors. This article reviews the evolution of transplant oncology and summarizes its characteristics, and particularly elaborates on the important role of transplant oncology in the precise treatment of liver cancer, especially the selection of recipients and expansion of the source of donor liver. It is highlighted that the prevention and treatment of tumor recurrence after liver transplantation for liver cancer and exploration of related mechanisms are still the major research directions in transplant oncology.

Prevention and control of HIV/AIDS in China: lessons from the past three decades / 中华医学杂志(英文版)

In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.

Evaluation on ophthalmic service ability of county hospitals based on improved DS evidence theory / 中华医院管理杂志

Objective:To evaluate the ophthalmic service ability of county hospitals in China based on the improved DS evidence theory.Methods:Convenient sampling method was used to select the data of ophthalmology department of 9 county hospitals in eastern, central and Western China in 2019. The improved DS evidence theory method based on Mahalanobis distance weight coefficient was applied to evaluate the medical service ability, and the evaluation results were compared with the classical evidence theory method.Results:The regional development of ophthalmic service capacity in counties of China was uneven, and there were regional differences in the evaluation results of some indicators. Hospitals in the eastern region were generally leading in the evaluation of a number of indicators related to the amount of medical services. The numbers of inpatient operations, outpatient operations, bed turnover times, bed utilization rate, number of inpatients, number of outpatients, number of patients in the eastern region were 3.25, 1.60, 1.81, 1.61, 2.64, 2.63 and 4.47 times of the numbers of hospitals in western region. Compared with the classical evidence theory method, the analysis results of the improved DS evidence theory method were consistent with the actual business development of each hospital, and the evaluation results were credible, which could more effectively reduce the uncertainty in the evaluation results.Conclusions:Ophthalmic service ability of county hospitals in China needs to be continuously improved. Improved DS evidence theory can be adopted to make continuous evaluation.

Predictive effect of liver fibrosis score and other factors on the prognosis of liver transplantation for liver cancer / 中华器官移植杂志

Objective:To explore the value of aspartate aminotransferase(AST)and platelet (PLT)ratio index(APRI)in the prognosis of liver transplantation(LT)for hepatocellular carcinoma and establish a nomogram model for evaluating its clinical application potential.Methods:From January 2015 to December 2019, retrospective review was conducted for clinical data of LT for hepatocellular carcinoma(HCC)at First Affiliated Hospital of Zhejiang University School of Medicine and Shulan(Hangzhou)Hospital(601 cases). They were randomized into two groups of modeling (399 cases)and validation(202 cases)and then divided into low and high APRI groups according to the APRI value at Month 1 post-transplantation. The independent risk factors of recurrence and prognosis post-LT were screened in modeling group using univariate and multivariate Cox regression analyses and were further used for constructing a nomogram prediction model. The receiver operating characteristic curve(ROC)and survival curve were utilized for verifying the accuracy of nomogram prediction model.Results:Univariate and multivariate Cox regression analyses revealed that independent risk factors for the prognosis of HCC-LT included cold ischemic time(CIT) >8 h, beyond Hangzhou criteria, surgical bleeding volume >1 000 ml and APRI >1.5. The AUC of HCC-LT recurrence prediction model was 0.734(95%CI: 0.681~0.787)and 0.749(95%CI: 0.671~0.817)in modeling and validation groups; the AUC of HCC-LT mortality prediction model was 0.735(95%CI: 0.679~0.790)and 0.758(95%CI: 0.682~0.834)in modeling and validation groups.Conclusions:APRI>1.5 is an independent risk factor for postoperative recurrence and mortality after HCC-LT. The nomogram prediction model based upon CIT, Hangzhou criteria, intraoperative bleeding volume and APRI can effectively predict the recurrence and overall survival of LT for HCC.

Study on the activity concentration of total α and natural radionuclides in drinking water in Inner Mongolia region / 中华放射医学与防护杂志

Objective:To ascertain the level of radioactivity in drinking water in Inner Mongolia region, and analyze the reasons why the total alpha radioactivity index is high in drinking water in some areas thereof.Methods:Water samples with high total alpha radioactivity index were collected in some towns in the region on the basis of surveyed result , with the causes of abnormal radioactivity index being analyzed, using low background α radioactivity measuring instrument, microuranium analyzer, and inductively coupled plasma mass spectrometer, to estimate the accumulative effective dose caused by ingestion of radioactivity in drinking water.Results:The total alpha activity was 0.508-1.008 Bq/L in tap water samples and 0.507-1.965 Bq/L in finished water samples. Uranium concentration was 3.41-35.71 μg/L in tap water measured using laser fluorescence method and 3.62-32.61 μg/L in finished water measured using laser fluorescence method, respectively. The concentration of 238U and 232Th in tap water measured by inductively coupled plasma mass spectrometry was 5.83-34.36 μg/L, 0.002-0.359 μg/L, respectively, while that in finished water was 5.62-29.41 μg/L, 0.003-0.327 μg/L, respectively. Conclusions:Based on the repeated measurement analysis of drinking water samples from some areas in Inner Mongolia, the high level of total α radioactivity in water samples is caused by uranium, and the high content of uranium leads to a high total alpha value.

Herbal Textual Research of Poria in Famous Classical Formulas / 中国实验方剂学杂志

This review made a systematic textual research on the historical evolution and changes of the origin， producing areas and quality， harvest time and processing methods， and cultivation technique of Poria in famous classical formulas from the Catalogue of Ancient Famous Classical Formulas （the First Batch） by referring to the literature of ancient materia medica and medical books combining with the modern literature in CNKI， Wanfang Data and other databases， which could provide reference for the development and research of the famous classical formulas containing Poria. According to the research， the origin of Poria in ancient times was the dried sclerotia of Poria cocos. The producing area of Poria is widely distributed in China， mainly produced in Anhui， Hubei， Henan and Yunnan provinces. The quality of Poria from Yunnan is better， and the yield is larger in Anhui and Hubei provinces. The quality evaluation of Poria is basically the same from ancient to modern， which has the characteristics of large block， heavy weight， thin and wrinkled skin， and white and delicate cross section. The harvesting period of Poria is usually in August of the lunar calendar. The initial processing has undergone the evolution from drying in shade in the ancient time to drying in shade after sweating in the modern time. From ancient times to the present， Poria has been processed by cutting to prepare the Fuling lumps and Fuling slices. The cultivation technique has experienced the evolution process of "wild Poria-inoculation of live pine root-basswood cultured". At present， Poria is mainly cultivated by artificial basswood with mature technical methods and abundant yields， which can meet the research and development needs of the famous classical formulas.

Comparison of UPLC Fingerprint and Determination of Index Components Before and After Processing of Cyperi Rhizoma Processed with Four Excipients / 中国实验方剂学杂志

Objective:To study the quality evaluation method of Cyperi Rhizoma processed with four excipients. Method:Ultra-performance liquid chromatography （UPLC） fingerprints of raw products and processed products with four excipients of Cyperi Rhizoma were established， and the changes of chemical components in the fingerprints before and after processing were compared by chemometric analysis. The mobile phase was consisted of methanol （A）-water （B） for gradient elution （0-10 min， 5%-40%A； 10-30 min， 40%-70%A； 30-40 min， 70%A） at a flow rate of 0.3 mL·min^-1. The injection volume was 3 μL， the column temperature was 35 ℃， and the detection wavelength was 280 nm. The content changes of main index components in Cyperi Rhizoma before and after processing were compared by UPLC. The mobile phase was methanol-water （75∶25） and the detection wavelength was 242 nm. Result:Processing with four excipients had a significant impact on the overall characteristics of chemical components in the fingerprint of Cyperi Rhizoma. A total of 28 characteristic peaks were identified in fingerprints of the raw and processed products. Among them， peaks 1， 2 and 4 were specific peaks of the processed products， peak 5 was characteristic peak of the raw products. Peak 2 was identified as 5-hydroxymethylfurfural， peak 24 as cyperenone and peak 27 as <italic>α</italic>-cyperone. The 5-hydroxymethylfurfural produced by the processing with four excipients came from rice vinegar， rice wine and Maillard reaction of polysaccharides in Cyperi Rhizoma. The results of determination showed that there was no significant difference in the content of cyperenone after processing， but the content of <italic>α</italic>-cyperone decreased significantly. Conclusion:In the process of Cyperi Rhizoma processed with four excipients， there are new components produced by structural transformation， which are accompanied by changes in the content of index components. In this study， the quality of raw and processed products of Cyperi Rhizoma can be rapidly and effectively evaluated from qualitative and quantitative aspects.

Comparison of UPLC Fingerprint and Determination of Main Components Before and After Processing of Artemisiae Argyi Folium Processed with Four Excipients / 中国实验方剂学杂志

Objective:To establish the ultra-performance liquid chromatography （UPLC） fingerprints of Artemisiae Argyi Folium and Artemisiae Argyi Folium processed with four excipients， and quantitatively analyze the 8 phenolic acids and flavonoids contained in them， in order to explore the quality evaluation method of Artemisiae Argyi Folium processed with four excipients. Method:UPLC was used with Shim-pack XR-ODS C₁₈ column （2.0 mm×75 mm， 2.2 µm）， mobile phase of acetonitrile （A） -0.2% formic acid aqueous solution （B） for gradient elution （0-1 min， 10%A； 1-2 min， 10%-15%A； 2-17 min， 15%-18%A； 17-24 min， 18%-28%A； 24-36 min， 28%-38%A； 36-41 min， 38%-60%A； 41-45 min， 60%-100%A）， detection wavelength of 330 nm and flow rate of 0.2 mL·min^-1. The UPLC fingerprints of Artemisiae Argyi Folium before and after processing were established， and analyzed by chemometrics. Contents of 5-caffeoylquinic acid， 3-caffeoylquinic acid， 4-caffeoylquinic acid， 3，4-dicaffeoylquinic acid， 3，5-dicaffeoylquinic acid， 4，5-dicaffeoylquinic acid， jaceosidin and epuatilin in the decoction pieces were determined. Result:The fingerprints of Artemisiae Argyi Folium before and after processing were established， and the UPLC characteristic chromatograms of Artemisiae Argyi Folium before and after processing had good consistency， and the similarity was >0.94. Compared with Artemisiae Argyi Folium， the contents of 3-caffeoylquinic acid and 3，4-dicaffeoylquinic acid had no significant change after processing， the contents of jaceosidin and epuatilin decreased after processing， while the contents of 5-caffeoylquinic acid， 4-caffeoylquinic acid and 4，5-dicaffeoylquinic acid increased significantly （<italic>P<</italic>0.01）， their average increasing rates were 32.50%， 66.83%， 29.39%， respectively. And content of 3，5-dicaffeoylquinic acid was significantly decreased （<italic>P<</italic>0.01） ， and the average reduction rate was 51.25%. Conclusion:The contents of chemical components in Artemisiae Argyi Folium and Artemisiae Argyi Folium processed with four excipients have changed to a certain extent. Among them， 5-caffeoylquinic acid， 3，5-dicaffeoylquinic acid， 4-caffeoylquinic acid and 4，5-dicaffeoylquinic acid can be used as the key indicators for quality evaluation of Artemisiae Argyi Folium before and after processing.

Analysis of the Genome Sequence of Strain GiC-126 of Gloeostereum incarnatum with Genetic Linkage Map

Gloeostereum incarnatum has edible and medicinal value and was first cultivated and domesticated in China. We sequenced the G. incarnatum monokaryotic strain GiC-126 on an Illumina HiSeq X Ten system and obtained a 34.52-Mb genome assembly sequence that encoded 16,895 predicted genes. We combined the GiC-126 genome with the published genome of G. incarnatum strain CCMJ2665 to construct a genetic linkage map (GiC-126 genome) that had 10 linkage groups (LGs), and the 15 assembly sequences of CCMJ2665 were integrated into 8 LGs. We identified 1912 simple sequence repeat (SSR) loci and detected 700 genes containing 768 SSRs in the genome; 65 and 100 of them were annotated with gene ontology (GO) terms and KEGG pathways, respectively. Carbohydrate-active enzymes (CAZymes) were identified in 20 fungal genomes and annotated; among them, 144 CAZymes were annotated in the GiC-126 genome. The A mating-type locus (MAT-A) of G. incarnatum was located on scaffold885 at 38.9 cM of LG1 and was flanked by two homeodomain (HD1) genes, mip and beta-fg. Fourteen segregation distortion markers were detected in the genetic linkage map, all of which were skewed toward the parent GiC-126. They formed three segregation distortion regions (SDR1–SDR3), and 22 predictive genes were found in scaffold1920 where three segregation distortion markers were located in SDR1. In this study, we corrected and updated the genomic information of G. incarnatum. Our results will provide a theoretical basis for fine gene mapping, functional gene cloning, and genetic breeding the follow-up of G. incarnatum.