A brief discussion on the inspiration and thinking of the Metaverse concept to promote the innovative development of intelligent medicine in China / 中华外科杂志

Created by digital technology,the Metaverse is a digital platform where the digital virtual world and the actual real world can coexist to some extent. Based on the integration of Metaverse and medical science,this article describes the great development of intelligent medicine in the fields of medical practice,medical education and medical research,especially in the field of surgery. First,the technical source of the Metaverse concept in the field of intelligent medicine can be traced back to technology to generate actual digital data sets from human anatomy. Second,the successful industrial practice of Metaverse in the field of intelligent medicine conforms to the authentic and credible fundamental purpose of "taking people as the first priority and serving people"， that is， "virtual" must be based on "actual" for "actual".

Patent Analysis of TCM for Treating Gastric Cancer in China Based on Patent Analysis and SWOT Model / 中国药房

OBJECTIVE：To provide reference for the R&D of TCM patents for treating gastric cancer and layout. METHODS：TCM patents for treating gastric cancer collected by the State Intellectual Property Office and the European Patent Office Espacenet were retrieved from the inception to Dec. 31st， 2019. After the initial examination ，a second search was conducted based on the keywords such as “Stomachache”“Fuliang” “Accumulation”“Cancer of stomach ”“Gastric”and their synonyms. Each literature was read one by one and screened manually. Excel 2007 software was used to input general information of included patents. SPSS modeler 15.0 software and SPSS 22.0 software were used for association rule analysis and hierarchical cluster analysis of TCM used more than 30 times and top 30 frequently used. Based on patent analysis ，internal strength （S），weakness（W），external opportunity （O）and threat （T）of TCM for treating gastric cancer were analyzed ；based on this ，four different types of combination strategies were formulated. RESULTS & CONCLUSIONS ：Finally，385 patents were obtained ，including 379 domestic patents （98.44％） and 6 foreign patents （1.56％）. The number of patent applications and applicants of TCM for treating gastric cancer in China was on the rise during 1994-2016. The commonly used TCM for treating gastric cancer were mainly tonifying deficiency drugs and heat clearing drugs ， and the meridian tropism were mostly the stomach meridian and spleen meridian. According to the efficacy ，the commonly used drug combinations include the combination of tonifying spleen and Qi ，the combination of anti-cancer and detoxification ，and the combination of drying dampness and resolving phlegm. The results of hierarchical cluster analysis showed that Poria cocos ， Atractylodes macrocephala ，Astragalus membranaceus ，Scutellaria barbata ，Hedyotis diffusa and Glycyrrhiza uralensis were clustered into one category and the common combination for treating gastric cancer. The remaining cluster distributions are also in line with the characteristics of TCM syndrome differentiation and treatment. Strength of domestic TCM patents for treating gastric cancer were that the number of patents in China was taking a leading position in the world ，the patent system of key applicants was mature，the combination of compound patents embodied the characteristics of disease and dialectical theory. Weakness included low patent authorization rate ，to-be-improved effectiveness and safety studies of TCM patents ，weak development of TCM extract patents，low degree of patent internationalization and hanging same-family patents. Opportunities were that the demand for drugs for gastric cancer was increasing with each passing day ，and natione actively support the development of the TCM industry. Threats were that competitors in the international market had the potential to seize the market. The development of TCM for treating gastric cancer in China should take market demand and national policy support as an opportunity ，learn from TCM patent characteristic system of key applicants ，continue to give full play to the advantages of TCM in prevention and syndrome differentiation of disease，pay more efforts to the development of weak links such as TCM extracts ，safety and effectiveness ，improve the international competitiveness in the field of patents ，while establish a warning and navigation analysis system for patents to effectively reduce the intellectual property threats and risks of invention patents of China in the international environment.

Drug analysis based on scalable moving-window similarity and Bayesian method by Raman spectroscopy / 药学实践杂志

Objective To propose scalable moving-window similarity combined with Bayesian for rapid discriminating low active pharmaceutical ingredient(API)signal drugs(LAPIDs).Methods The scalable moving-window similarity method was employed by setting the window size dynamically according to API′s peak width.In each window,the correlation coefficient (CC)of API′s peak spectrum signal with LAPID′s spectrum and LAPID′s spectrum with excipient′s spectrum were calculated respectively.The LAPIDs discrimination model was established by choosing windows with most contribution of the API spec-tral signal to the LAPID spectrum as variables for Bayesian discriminant model.Results The accuracy rate of LAPIDs discrim-ination model for discriminating LAPIDs was 94.7%.The accuracy rate of the model for discriminating testing samples was 95.6%.Conclusion Bayesian discrimination model based on scalable moving-window similarity and Bayesian algorithm can quickly discriminate LAPIDs.

Expression of hsa_circ_PVT1 in human hepatocellular carcinoma and its clinical significance / 解放军医学杂志

Objective To determine the expression and clinical significance of circ-PVT1 in human hepatocellular carcinoma (HCC) and its effect on HCC cell proliferation.Methods The expressions of circ-PVT1 in hepatocellular carcinoma and the matched tumor-adjacent tissues were detected by RT-qPCR and the relationship between pathological indexes and the expression level was analyzed in 46 patients.The expressions of circ-PVT1 in human normal liver cell line (L02) and hepatocellular carcinoma cell lines (HepG2,SMMC-7721,MHCC-97H,MHCC-97L,HCC-LM3) were detected by RT-qPCR and were compared thereafter.With knocking down the expression of circ-PVT1,si-circPVT1 was transfected into HepG2 and SMMC-7721 cells by using lipofectamine technique in vitro,with the si-NC being taken as negative control.After interfering the expression of circ-PVT1,the effect on the proliferation of hepatocellular carcinoma cells was detected by CCK-8 and EDU experiments and flow cytometry was conducted to observe the effect of circ-PVT1 on cell cycle.Results The expression level of circ-PVT1 was significantly higher in HCC tissues than in adjacent tissues (P＜0.01),and its high expression level was significantly correlated with tumor size,TNM stage and differentiation degree.Similarly,in human hepatocellular carcinoma cell lines (HepG2,SMMC-7721,MHCC-97H,MHCC-97L,HCC-LM3),the expression level of circ-PVT1 was also higher than that in human normal liver cell line L02 (P＜0.05).Compared with the negative control group,silencing of circ-PVT1 resulted in remarkable reduction in cell proliferation of HepG2 and SMMC-7721.Conclusion circ-PVT1 may act as a potential biomarker for HCC diagnosis and may become a novel proliferation factor.

Pulmonary embolism excluded acute coronary syndrome by coronarography: a retrospective analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pulmonary embolism (PE) is often mistaken as acute coronary syndromes (ACS) because of the considerable overlap in their clinical features. We evaluated the factors causing misdiagnosis of PE as ACS and factors that differentiate PE from ACS to improve the diagnosis efficacy of PE.</p><p><b>METHODS</b>The medical records of 22 consecutive PE patients, between 2001 and 2010, who were initially suspected of ACS were retrieved. ACS was ruled out by coronary artery angiography before a definite diagnosis of PE was given. Twenty-two contemporary cases of ACS matched by age and sex were recruited as controls. Clinical manifestations, electrocardiograms (ECG), and biomarkers of these patients were reviewed retrospectively. The factors causing misdiagnosis of PE as ACS and factors differentiating PE from ACS were evaluated.</p><p><b>RESULTS</b>We found two leading causes of misdiagnosis of PE as ACS. One is that PE can resemble ACS in several clinical aspects (symptoms and signs, ECG findings, plasma cardiac troponin I, and D-dimer). The other is the insufficient recognition of PE by clinicians. Risk factors for venous thromboembolism (VTE), especially deep venous thrombosis (DVT), together with signs of PE, such as unexplained dyspnea or hypoxemia, and right ventricular pressure overload on ECGs are valuable in differentiating the two diseases.</p><p><b>CONCLUSIONS</b>Differentiation between PE and ACS is sometimes challenging. Adequate awareness of the risk factors for VTE and the signs of PE are crucial in the diagnosis of PE.</p>

HPLC fingerprint of citri grandis exocarpium from different cultivars / 中国中药杂志

<p><b>OBJECTIVE</b>To study the quality difference among Citrus grandis 'Tomentosas' of different cultivars, in order to provide scientific basis for seeking for fine breeds.</p><p><b>METHOD</b>The HPLC fingerprints were established for C. grandis 'Tomentosa' of different cultivars in the GAP base of Huazhou Green Life Co., Ltd. The software of similarity evaluation system of traditional Chinese medicine HPLC fingerprints 2004A edition of Chinese Pharmacopoeia Commission was adopted for the similarity analysis and judgment of cultivars.</p><p><b>RESULT</b>The fingerprints showed similar general characteristics of samples of different cultivars. Specifically, the similarity of areas of the 18 common peaks ranged between 0.938-0.998. The success rate of judging cultivars using similarity software stood at 92%.</p><p><b>CONCLUSION</b>This method can be applied to better identify quality and source of cultivars of C. grandis 'Tomentosa', and provide technical measures and scientific basis for seeking for fine breeds of Citri Grandis Exocarpium.</p>

Depression, anxiety and influencing factors in patients with acute pulmonary embolism / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Psychological distress has been widely studied in many cardiovascular and pulmonary diseases, but the condition in acute pulmonary embolism (APE) is unknown. The purpose of this study was to investigate levels of depression and anxiety and their influencing factors in APE patients.</p><p><b>METHODS</b>Sixty consecutive patients with APE were subjected to investigation of depression and anxiety by the Beck Depression Inventory and State-Trait Anxiety Inventory, and 60 community-based subjects were enrolled as controls. APE patients were stratified as high-risk, intermediate-risk and low-risk according to the disease severity. Scores of depression and anxiety were compared by statistical analysis using paired t tests between APE patients and controls, and by analysis of variance within the APE patients with the three risk stratification. Factors influencing depression and anxiety were evaluated.</p><p><b>RESULTS</b>The mean age of the patients (38 males and 22 females) was (52 ± 12) years. APE patients displayed higher scores of depression (P = 0.04) and anxiety (P = 0.001) compared with controls. Patients in the high-risk group displayed higher scores of depression (P = 0.004) and anxiety (P = 0.001) compared with those in the intermediate- and low-risk groups. Depression scores were highly correlated with anxiety scores (r = 0.60, P < 0.001). Both depression and anxiety inversely related to risk stratification (P < 0.01), age (P < 0.05), and arterial blood oxygen pressure (PaO2) (P < 0.05). Linear regression analysis showed that PaO2 was independently inversely related to both depression (P < 0.01) and anxiety (P < 0.05); risk stratification and age were independently inversely related to anxiety (P < 0.05).</p><p><b>CONCLUSIONS</b>Patients of APE suffered high levels of depression and anxiety, which were negatively influenced by PaO2, risk stratification and age.</p>