Herbal Textual Research on Pharbitidis Semen in Famous Classical Formulas / 中国实验方剂学杂志

By consulting the ancient and modern literature， the textual research of Pharbitidis Semen has been conducted to clarify the name， origin， distribution of production areas， quality specification， harvesting， processing and so on， so as to provide reference for the development and utilization of the relevant famous classical formulas. Through textual research， it can be seen that Pharbitidis Semen was first published in Mingyi Bielu（《名医别录》）， and all dynasties have taken Qianniuzi as the correct name. Based on the original research， the main source of Pharbitidis Semen used in previous dynasties is the dried mature seeds of Pharbitis nil， which is consistent in ancient and modern times. The white Pharbitidis Semen appearing in Compendium of Materia Medica（《本草纲目》） from Ming dynasty is similar to the present P. purpurea. It is produced all over the country， and the quality is better if the particles are full and free of impurities. In ancient times， the harvesting time was mostly in the September. Now it is autumn. The fruits are ripe and harvested， dried to remove impurities for standby. In ancient times， the processing methods of Pharbitidis Semen were mainly wine steaming， steaming and frying until half cooked and grinding the head and end. In modern times， they have been simplified to stir-frying method. The nature， taste， meridian tropism and their effects also change supplements with the deepening of practice. Before the Ming dynasty， they were all bitter， cold and toxic. In the Ming dynasty， there appeared the characteristics of pungent， hot and small poisonous. The efficacy has evolved from controlling low Qi， curing foot edema， removing wind toxin， and facilitating urination to facilitating water and defecation， eliminating phlegm and drinking， and eliminating accumulated insects. The main clinical contraindications are those with weak spleen and kidney， those with weak spleen and stomach， pregnant women， and should not be used with croton and croton cream. Based on the textual research， it is suggested that when developing the classic famous formula with Pharbitidis Semen as the main raw material in the future， it is clear that the source should be the dried mature seeds of Pharbitis nil（black product is its black-brown seeds， white product is its beige seeds）. The processing requirements indicated in the original formula are all processed according to the requirements， and the raw product is recommended to be used as medicine if not specified.

Association between hemoglobin glycation index and 5-year major adverse cardiovascular events: the REACTION cohort study / 中华医学杂志(英文版)

BACKGROUND@#The hemoglobin glycation index (HGI) was developed to quantify glucose metabolism and individual differences and proved to be a robust measure of individual glycosylated hemoglobin (HbA1c) bias. Here, we aimed to explore the relationship between different HGIs and the risk of 5-year major adverse cardiovascular events (MACEs) by performing a large multicenter cohort study in China.@*METHODS@#A total of 9791 subjects from the Risk Evaluation of Cancers in Chinese Diabetic Individuals: a Longitudinal Study (the REACTION study) were divided into five subgroups (Q1-Q5) with the HGI quantiles (≤5th, >5th and ≤33.3th, >33.3th and ≤66.7th, >66.7th and ≤95th, and >95th percentile). A multivariate logistic regression model constructed by the restricted cubic spline method was used to evaluate the relationship between the HGI and the 5-year MACE risk. Subgroup analysis between the HGI and covariates were explored to detect differences among the five subgroups.@*RESULTS@#The total 5-year MACE rate in the nationwide cohort was 6.87% (673/9791). Restricted cubic spline analysis suggested a U-shaped correlation between the HGI values and MACE risk after adjustment for cardiovascular risk factors ( χ2 = 29.5, P <0.001). After adjustment for potential confounders, subjects with HGIs ≤-0.75 or >0.82 showed odds ratios (ORs) for MACE of 1.471 (95% confidence interval [CI], 1.027-2.069) and 2.222 (95% CI, 1.641-3.026) compared to subjects with HGIs of >-0.75 and ≤-0.20. In the subgroup with non-coronary heart disease, the risk of MACE was significantly higher in subjects with HGIs ≤-0.75 (OR, 1.540 [1.039-2.234]; P = 0.027) and >0.82 (OR, 2.022 [1.392-2.890]; P <0.001) compared to those with HGIs of ≤-0.75 or >0.82 after adjustment for potential confounders.@*CONCLUSIONS@#We found a U-shaped correlation between the HGI values and the risk of 5-year MACE. Both low and high HGIs were associated with an increased risk of MACE. Therefore, the HGI may predict the 5-year MACE risk.

Primer probes for targeted identification and detection of Bifidobacterium animalis and their application / 中国药科大学学报

@#In this study, in order to overcome the shortcomings of the current methods used to identify Bifidobacterium animalis, such as long time, complicated operation and low adaptability of experimental environment, specific primer probes were designed based on ERIC-PCR technology to identify and detect B.animalis.Based on the genomic DNA of B.animalis HP-B1124, the ERIC-PCR reaction conditions of B.animalis HP-B1124 were optimized, and the ERIC-PCR fragments were obtained one by one and sequenced.Two pairs of specific primer probes were designed.The accuracy, specificity, limitation and universality of the two pairs of primer probes were evaluated, and the two pairs of specific primer probes were used for testing the products containing B.animalis in the commercially published formula.The two pairs of specific primer probes designed in this study could be used for identified strains of B.animalis more simply, quickly and targeted.This method has optimized the current relatively traditional methods of pure culture and plate counting identification of B.animalis, and has solved the high requirements of SNP genotyping technology and real-time fluorescence quantitative PCR method for experimental equipment and reagents in the identification of B.animalis to a certain extent.It has the characteristics of low cost, high specificity and earn a broad market development prospect.

Clinical study of Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine in the treatment of ischemic stroke with qi-deficiency blood stasis syndrome / 国际中医中药杂志

Objective:To evaluate the effect of Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine on ischemic stroke.Methods:Prospective cohort study. According to random number table method, 120 patients with ischemic stroke who met inclusion criteria in the hospital were divided into control group and treatment group, 60 in each group. The control group was given routine western medicine, while the treatment group was additionally given Banxia Baizhu Tianma Decoction and modified Buyang Huanwu Decoction. All were treated for 4 weeks. The severity of neurological deficits was evaluated by National Institute of Health Stroke Scale (NIHSS). The activities of daily living were evaluated by Barthel index. The high blood shear viscosity (HWBV), low blood shear viscosity (LWBV), plasma fibrinogen (FIB) and plasma viscosity (PV) were detected by full-automatic blood rheometer. The levels of MDA, SOD and NO were detected by ELISA. The clinical responsive rate was assessed.Results:The differences in total response rate between treatment group and control group were statistically significant [93.3% (56/60) vs. 75.0% (45/60), χ2=7.56, P=0.006]. After treatment, NIHSS score in treatment group was significantly lower than that in control group ( t=2.38, P=0.019), while Barthel index was significantly higher than that in control group ( t=13.28, P<0.01). After treatment, HWBV [(5.02±0.13) mPa?s vs. (6.18±0.28) mPa?s, t=29.11], LWBV [(1.18±0.21) mPa?s vs. (1.73±0.32) mPa?s, t=11.13], FIB [(2.26±0.28) g/L vs. (3.13±0.39) g/L, t=14.04] and PV [(8.87±1.44) mPa?s vs. (10.34±1.31) mPa?s, t=5.85] in treatment group were significantly lower than those in control group ( P<0.01), and the MDA [(4.14±1.23) mmol/L vs. (5.23±1.35) mmol/L, t=204.30] in treatment group was significantly lower than that in control group ( P<0.01), and levels of SOD [(113.34±0.28) mg/L vs. (96.59±0.57) mg/L, t=4.62] and NO [(26.01±3.26) μmol/L vs. (20.84±3.74) μmol/L, t=8.07] in treatment group were significantly higher than those in control group ( P<0.01). Conclusion:The Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine can repair nerve function, improve hemorheology, oxidative stress indexes, clinical curative effect and activities of daily living in patients with ischemic stroke.

Quality evaluation of Cnidii Fructus in commodity grade based on theory of "quality evaluation through morphological identification" / 中国中药杂志

From the perspective of market classification of Cnidii Fructus, this paper revealed the scientific connotation of evaluating the quality grade of Cnidii Fructus by its appearance traits. Thirty batches of Cnidii Fructus in different grades were selected as the research objects. The canonical correlation analysis and principal component analysis(PCA) were used to explore the measurement values of 15 appearance traits and intrinsic content indexes. The results of correlation analysis showed that except the aspect ratio, the 5 appearance trait indexes(length, width, 1 000-grain weight, broken grain weight proportion, and chroma) and 9 internal content indexes(the content of moisture, total ash, acid insoluble ash, osthole, imperatorin, 5-methoxy psoralen, isopimpinellin, xanthotoxin, and xanthotol) showed significant correlation to varying degrees. In addition, there was a significant positive correlation between the first typical variable U_1 composed of appearance traits and the first typical variable V_1 composed of internal content indexes(CR_1=0.963, P<0.01). The results of PCA showed that the classification results of appearance traits for 30 batches of Cnidii Fructus were consistent with the actual information of the samples. Under the same analysis conditions, 30 batches of Cnidii Fructus were reclassified by 9 groups of internal content indexes, and the analysis results were consistent. From the classification standard of the appearance traits of the system study, the statistical results of 6 appearance traits of Cnidii Fructus showed a correlation with grades. There was a good correlation between the appearance and the internal content of Cnidii Fructus, and the appearance quality effectively predicted the level of the internal content. There is a certain scientific basis for the quality classification of Cnidii Fructus by main appearance traits. Appearance classification can replace quality grading to realize the "quality evaluation through morphological identification" of Cnidii Fructus.

Effects of Attachment Wear on Tooth Movement: A Finite Element Analysis / 医用生物力学

Objective To explore the effect of attachment wear on tooth movement in clear Aligner treatment, and to provide references for improving the efficiency of orthodontic treatment. Methods The tooth cone bean computed tomography (CBCT) scanning data were obtained, and the tooth model was established and assembled with the worn and complete attachment, respectively. When the appliance applied 2° distal torsion, 0.25 mm distal displacement, 0.1 mm depression displacement and 0.1 mm elongation displacement to the teeth, the changes of tooth displacement, periodontal ligament stress and root equivalent stress in the worn and complete attachment groups were compared. Results When the clear Aligner was used to apply distal torsion and elongation displacement to the teeth, the maximum tooth displacement decreased significantly, and the worn attachment caused the teeth to move obliquely when the distal translation and elongation displacement occurred. When the tooth was subjected to distal torsion, distal translation, depression and elongation, the maximum principal stress of periodontal ligament and the equivalent stress of tooth root decreased when the worn attachment caused the tooth to be subjected to distal torsion, distal translation, depression and elongation. Conclusions Attachment wear will affect the efficiency of tooth rotation and elongation.When the attachments are obviously worn, they should be replaced in time to ensure normal function of the attachments.

Spatial Distribution Pattern of Medicinal Plant Resources in Gansu Province and Driving Factors / 中国实验方剂学杂志

ObjectiveTo clarify the spatial distribution characteristics of medicinal plant resources in Gansu province， analyze the causes， changing trends， and driving factors of the spatial differentiation， and thus lay a scientific basis for the rational development and sustainable development of medicinal plant resources in this province. MethodBased on the data of The Fourth National Survey of Chinese Medicine Resources， the richness and spatial distribution difference of medicinal plant resources in 87 counties （districts） of Gansu province were analyzed via the global spatial autocorrelation analysis， trend surface analysis， local spatial autocorrelation analysis， and hotspot analysis. Moreover， the correlation of vegetation type， soil texture， annual average temperature， annual average precipitation， and altitude with the spatial distribution pattern of the medicinal plant resources was discussed. ResultCounties （districts） with high or low richness of medicinal plant resources in Gansu province were respectively clustered together. To be specific， counties （districts） with high richness of the medicinal resources were mainly in southeastern Gansu， while those with low richness in northwestern Gansu. The leading driving factors affecting the cold and hot spots included vegetation type， soil texture， and average annual rainfall. ConclusionThe species richness of medicinal plant resources in Gansu province rises from west to east and from north to south. The natural driving factors are the key to the diversity and spatial distribution pattern of medicinal plant resources， which show significant influence on them.

Quality Regionalization of Angelica sinensis in Genuine Producing Area / 中国实验方剂学杂志

Objective:To study on the quality regionalization of <italic>Angelica sinensis</italic>，in order to guide the rational cultivation of <italic>A. sinensis</italic>. Method:Through visits and field surveys，a total of 857 batches of <italic>A. sinensis</italic> were collected from different counties of Dingxi，relevant geographic information such as longitude，latitude，altitude of each sampling point were obtained by using the global positioning system（GPS），the content of 8 indexes in <italic>A. sinensis </italic>was detected by UPLC， and based on national ecological environment factor data，the suitability analysis of the quality of <italic>A. sinensis</italic> was performed by using MaxEnt，ArcGIS，SPSS. Result:The suitable areas of <italic>A. sinens </italic>were concentrated in central and southern Dingxi. In the suitable areas，the content of ferulic acid，coniferyl ferulate，senkyunolide H decreased from south to north，the content of chlorogenic acid decreased from north to south，the content of senkyunolide A，senkyunolide I decreased from east to west，the distribution regularity of butenyl phthalide was not strong，the highest-content areas were in western Min county，Qingyuan town of Qingyuan county，Shangwan Township and Huichuan town. The content of ligustilide was consistent in the suitable area，and the highest content were in the middle of Weiyuan county and the northern Tongwei county. The results showed that it had a higher index components and comprehensive quality in Min county，Zhang county，southern Weiyuan county and northern Tongwei county. Conclusion:In this study，the quality suitability areas of <italic>A. sinensis</italic> in Dingxi were graded. The chemical components and the quality suitability zoning maps were generated. The findings could provide references for the comprehensive utilization of <italic>A. sinensis</italic>，the selection and construction of high-quality <italic>A. sinensis</italic> raw material base，and the scientific guidance for the production and regional development of <italic>A. sinensis</italic> in Dingxi.

Quantitative analysis of total content differentiation and driving factors of phenolic acids in Angelicae Sinensis Radix of Gansu Dao-di herbs from perspective of geographical space / 中国中药杂志

Dao-di herbs, produced in a specific region and screened through long-term clinical application, is characterized by high stable quality, good efficacy, and high popularity. With favorable climate conditions, Gansu gives birth to the Dao-di herbs Angelicae Sinensis Radix which is widely used in clinical practice, and multiple regions in Gansu, with similar ecological environment produce Angelicae Sinensis Radix. In this study, the spatial correlation and difference of phenolic acid content in Angelicae Sinensis Radix from Dao-di producing areas, emerging producing areas, and emerging planting areas in Gansu were analyzed based on ArcGIS to explore the "quality(chemical type)" characteristics of genuine Angelicae Sinensis Radix. Moreover, spatial distribution law and main driving factors of the total phenolic acid content in Angelicae Sinensis Radix in Gansu were analyzed based on geodetecctor. This study is expected to lay a basis for Dao-di research and production regionalization of Angelicae Sinensis Radix.

Q-marker prediction of Magnoliae Officinalis Cortex before and after "sweating" / 中国中药杂志

Magnoliae Officinalis Cortex, a common Chinese medicinal in clinic, should undergo "sweating" process in producing area according to Chinese Pharmacopoeia, which affects its genuineness and quality. In light of the concept and research mode of quality marker(Q-marker) for decoction pieces, the active components of Magnoliae Officinalis Cortex pieces which altered significantly before and after "sweating" were identified in this study. The main pharmacodynamic material basis was clarified by pharmacodynamic, pharmacokinetic and drug property research, followed by the prediction of Q-markers of Magnoliae Officinalis Cortex before and after "sweating", for better improving its quality standard.

Quantifying the impacts of human mobility restriction on the spread of coronavirus disease 2019: an empirical analysis from 344 cities of China / 中华医学杂志(英文版)

BACKGROUND@#Since the outbreak of coronavirus disease 2019 (COVID-19), human mobility restriction measures have raised controversies, partly because of the inconsistent findings. An empirical study is promptly needed to reliably assess the causal effects of the mobility restriction. The purpose of this study was to quantify the causal effects of human mobility restriction on the spread of COVID-19.@*METHODS@#Our study applied the difference-in-difference (DID) model to assess the declines of population mobility at the city level, and used the log-log regression model to examine the effects of population mobility declines on the disease spread measured by cumulative or new cases of COVID-19 over time after adjusting for confounders.@*RESULTS@#The DID model showed that a continual expansion of the relative declines over time in 2020. After 4 weeks, population mobility declined by -54.81% (interquartile range, -65.50% to -43.56%). The accrued population mobility declines were associated with the significant reduction of cumulative COVID-19 cases throughout 6 weeks (ie, 1% decline of population mobility was associated with 0.72% [95% CI: 0.50%-0.93%] reduction of cumulative cases for 1 week, 1.42% 2 weeks, 1.69% 3 weeks, 1.72% 4 weeks, 1.64% 5 weeks, and 1.52% 6 weeks). The impact on the weekly new cases seemed greater in the first 4 weeks but faded thereafter. The effects on cumulative cases differed by cities of different population sizes, with greater effects seen in larger cities.@*CONCLUSIONS@#Persistent population mobility restrictions are well deserved. Implementation of mobility restrictions in major cities with large population sizes may be even more important.

Nursing Grading Evaluation System for Patients with Stroke at Home: Construction, Validity and Reliability / 中国康复理论与实践

Objective:To construct a nursing grading evaluation indicator system for patients with stroke at home to provide a basis for graded care. Methods:Based on literature analysis, qualitative interviews and panel meeting, an evaluation indicator system was preliminarily drafted. June to September, 2018, the indicator system was consulted to experts three times. It was used to evaluate 210 patients with stroke at home from September to December, 2018 to test its reliability and validity. Results:The effective recovery rates of the three times of consultation were 85.00%, 89.47% and 100%, and the authority coefficient were 0.878, 0.879 and 0.879. The indicator system included four first-level indicators, 30 second-level indicators and 120 items. The scale-level content validity index (CVI) universal agreement was 0.733, average CVI was 0.927; the item-level CVIs were 0.83 to 1.00. For the overall level, the Cronbach's α coefficient was 0.928, and the Guttman Spilt half-factor coefficient was 0.794. For the dimensions, the Cronbach's α coefficient and the Guttman Spilt half-factor coefficients were all above 0.700. The correlated coefficients inter-evaluator of each indicators were 0.492 to 0.963 (P< 0.05). Conclusion:The nursing grading evaluation indicator system for patients with stroke at home is simple and operable, with satisfactory reliability and validity to grade the level of care for patients with stroke at home.

Expression and significance of programmed death-1 and T-cell immunoglobulin- and mucin domain-3-containing molecule 3 in hepatocellular carcinoma / 临床肝胆病杂志

ObjectiveTo investigate the expression and clinical significance of programmed death-1 (PD-1) and T-cell immunoglobulin- and mucin domain-3-containing molecule 3 (TIM-3) in hepatocellular carcinoma (HCC). MethodsThe paraffin blocks of HCC tissue and adjacent tissue (＞1 cm from the tumor margin) were collected from 46 patients with HCC who underwent surgical treatment in No. 900 Hospital of The Joint Service and Security Force of The Chinese People’s Liberation Army from January 2013 to December 2015. Immunohistochemistry was used to measure the expression of PD-1 and TIM-3, and their association with clinicopathological features and prognosis was analyzed. The Wilcoxon test was used for comparison of paired ranked data, and a Spearman correlation analysis was used to investigate the correlation between ranked data; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison of survival rates between groups; the Cox regression model was used to perform a multivariate analysis. ResultsThe expression levels of PD-1 and TIM-3 in HCC tissue were higher than those in adjacent tissue (both P＜0.05). PD-1 was mainly localized in lymphocytes and TIM-3 was mainly localized in tumor-associated macrophages. The expression of PD-1 was positively correlated with that of TIM-3 in HCC tissue (rs=0.397, P=0.006). The expression level of PD-1 in HCC tissue was associated with tumor size (rs=0.480, P=0.001), portal vein tumor thrombus (rs=0.307, P=0.038), and TNM stage (rs=0.534, P＜0.001), and the expression level of TIM-3 was associated with portal vein tumor thrombus (rs=0.301, P=0.042), degree of pathological differentiation (rs=0356, P=0.015), and TNM stage (rs=0.416, P=0.004). For the patients with HCC, the 1-, 3-, and 5-year overall survival rates were 89.1%, 56.5%, and 34.4%, respectively, and the 1-, 3-, and 5-year disease-free survival rates were 52.2%, 21.7%, and 10.9%, respectively. The multivariate analysis showed that degree of pathological differentiation (hazard ratio ［HR］=4.723, 95% confidence interval ［CI］: 1.618-7.684, P=0.001), tumor size (HR=3.234, 95%CI: 1.327-7.883, P=0.010), TNM stage (HR=3.254, 95%CI: 1.076-9.835, P=0.037), and expression level of TIM-3 (HR=0.572, 95%CI: 0.329-0.995, P=0048) were independent prognostic factors for the overall survival of HCC patients, and degree of pathological differentiation (HR=2.945, 95%CI: 1.527-5.682, P=0.001) and TNM stage (HR=2.074, 95%CI: 1.259-9.793, P=0.016) were independent prognostic factors for the disease-free survival of HCC patients. ConclusionHigh expression levels of both PD-1 and TIM-3 are observed in HCC tissue, and PD-1 and TIM-3 may be involved in the progression and poor prognosis of HCC patients.

Dexamethasone protects the glycocalyx on the kidney microvascular endothelium during severe acute pancreatitis / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#This study demonstrated that dexamethasone (DEX) protects the endothelial glycocalyx from damage induced by the inflammatory stimulus tumor necrosis factor-α (TNF-α) during severe acute pancreatitis (SAP), and improves the renal microcirculation.@*METHODS@#Ninety mice were evenly divided into 3 groups (Sham, SAP, and SAP+DEX). The SAP mice model was established by ligature of pancreatic duct and intraperitoneal injection of cerulein. Renal perfusion and function, and morphological changes of the glycocalyx were evaluated by laser Doppler velocimetry, electron microscopy, and histopathology (hematoxylin and eosin (H&E) staining), respectively. Serum levels of syndecan-1 and TNF-α were assessed by enzyme-linked immunosorbent assay (ELISA). The protective effects of dexamethasone on the glycocalyx and renal microcirculation were evaluated.@*RESULTS@#Significantly high levels of serum TNF-α were detected 3 h after the onset of SAP. These levels might induce degradation of the glycocalyx and kidney hypoperfusion, resulting in kidney microcirculation dysfunction. The application of dexamethasone reduced the degradation of the glycocalyx and improved perfusion of kidney.@*CONCLUSIONS@#Dexamethasone protects the endothelial glycocalyx from inflammatory degradation possibly initiated by TNF-α during SAP. This is might be a significant discovery that helps to prevent tissue edema and hypoperfusion in the future.

Role of intestinal dysbacteriosis in the pathogenesis of acute-on-chronic hepatitis B liver failure / 临床肝胆病杂志

Acute-on-chronic liver failure is a clinical syndrome with acute exacerbation on the basis of chronic liver disease and can cause severe liver injury and dysfunctions of liver synthesis, detoxification, metabolism, and biotransformation. Intestinal dysbacteriosis is an important factor for the acceleration of liver failure. Therefore, it is important to prevent or delay the progression of liver failure by improving intestinal dysbacteriosis and liver function.

Role of intestinal dysbacteriosis in the pathogenesis of acute-on-chronic hepatitis B liver failure / 临床肝胆病杂志

Acute-on-chronic liver failure is a clinical syndrome with acute exacerbation on the basis of chronic liver disease and can cause severe liver injury and dysfunctions of liver synthesis, detoxification, metabolism, and biotransformation. Intestinal dysbacteriosis is an important factor for the acceleration of liver failure. Therefore, it is important to prevent or delay the progression of liver failure by improving intestinal dysbacteriosis and liver function.

Biosynthesis of clinically used antibiotic fusidic acid and identification of two short-chain dehydrogenase/reductases with converse stereoselectivity

Fusidic acid is the only fusidane-type antibiotic that has been clinically used. However, biosynthesis of this important molecule in fungi is poorly understood. We have recently elucidated the biosynthesis of fusidane-type antibiotic helvolic acid, which provides us with clues to identify a possible gene cluster for fusidic acid ( cluster). This gene cluster consists of eight genes, among which six are conserved in the helvolic acid gene cluster except and . Introduction of the two genes into the NSAR1 expressing the conserved six genes led to the production of fusidic acid. A stepwise introduction of and revealed that the two genes worked independently without a strict reaction order. Notably, we identified two short-chain dehydrogenase/reductase genes and in the cluster, which showed converse stereoselectivity in 3-ketoreduction. This is the first report on the biosynthesis and heterologous expression of fusidic acid.

A randomized controlled study of peramivir, oseltamivir and placebo in patients with mild influenza / 中华内科杂志

Objectives To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza.Methods This was a randomized,double-blind,double-dummy,placebo and positive control,multicenter clinical trial,comparing peramivir trihydrate with oseltamivir and placebo.The inclusive criteria were 15-70 years old,onset within 48 h,positive rapid influenza antigen test,and febrile(＞38℃) accompanied with at least two associated symptoms.The severe cases complicated with chronic pulmonary and cardiac diseases,malignancies,organ transplantation,hemodialysis,uncontrolled diabetes,immunocompromised status,pregnancy and coexistence of bacterium infections were excluded.All patients were randomized 2:2:1 to receive peramivir,oseltamivir and placebo respectively.The primary endpoint was the disease duration,the secondary endpoints included time to normal axillary temperature and normal living activities,viral response,and adverse effects.Results Following informed consent,133 patients were included in this study.Four patients were exclude due to missing medical records,not fitting inclusion or exclusion criteria and poor compliance.A total of 129 patients were finally analyzed,including 49 cases,54 cases and 26 cases in peramivir group,oseltamivir group and placebo group.The median disease duration were 96 (76,120)hours,105(90,124) hours,and 124 (104,172)hours in three groups respectively(P＞0.05).The time to normal axillary temperature,normal living activities and viral response were not significantly different in three groups(P＞0.05).Conclusion The value of antiviral therapy in patients with mild influenza needs to be further determined.

Efficacy of decompressive craniectomy combined with ipsilateral external ventricular drainage for severe traumatic brain injury / 中华创伤杂志

Objective To investigate the efficacy of decompressive craniectomy (DC) combined with ipsilateral external ventricular drainage (iEVD) for severe traumatic brain injury (sTBI). Methods A retrospective case control study was performed on the clinical data of 54 sTBI patients admitted to the First People's Hospital of Taizhou from January 2015 to March 2018. There were 38 males and 18 females, aged 18-72 years [ (51. 8 ± 15. 4)years]. The Glasgow Coma Scale (GCS) of patients ranged from 3 to 8 points. Among 54 patients, 27 received DC treatment, including 18 males and nine females aged (50. 1 ± 2. 9)years (DC group);27 patients received DC combined with iEVD, including 18 males and nine females aged (53. 4 ± 3. 1) years (DC-iEVD group). Intracranial pressure after surgery and complications ( hydrocephalus and subdural hygroma) 2 weeks after surgery, andModified Rankin Scale (mRS) 3 months after surgery were compared between the two groups. Results All patients were followed up for 2.5-4 months [(3.0 ±0.8)months]. No significant difference was found in intracranial pressure at postoperative 12 hours and 24 hours between the two groups (P>0. 05). However, the intracranial pressure of DC-iEVD group were significantly lower than those of DC group at 36, 48, 60 and 72 hours after operation (P<0. 05). The hydrocephalus incidence 2 weeks after surgery of DC-iEVD group was 15％ (4/27), while that of DC group was 7％ (2/27)(P >0. 05). The subdural effusion incidence 2 weeks after surgery of DC-iEVD group was 19％ (5/27), while that of DC group was 44％ (12/27) (P<0. 05). According to mRS, patients with good outcome in DC-iEVD group accounted for 63％(17/27) while the ratio was 44％ (12/27) in DC group. The prognosis of DC-iEVD group was slightly better than that of DC group, but the difference was not statistically significant(P>0. 05). Conclusion For sTBI, combined use of DC and iEVD can better control intracranial pressure and reduce the occurrence of subdural effusion.

Impact of WeChat-assisted follow-up on the self-administer medication capability of stroke survivors / 中华行为医学与脑科学杂志

Objective To explore the impact of WeChat-assisted follow-up on self-administer medication capability of stroke survivors.Methods Seventy patients were recruited from a tertiary hospital and randomly divided into intervention group (n=35) and control group (n=35).Patients in intervention group were given WeChat-assisted follow-up including health education program and behavior guidance,and patients in control group received regular discharge care.The effects of WeChat-assisted follow-up and regular care on self-administer medication ability,cognitive and behavior level were assessed.Results After three months' follow-up,the scores of self-administer medication capability (38 (32,42)),experience (25 (20,28) and the integral level (87 (71,92)) in intervention group were significantly higher than those in control group (capability 25(16,38),experience 21 (8.75,27),total score 68 (38,87)) (Z=-2.511,-2.033,-2.209,P＜0.05).The self-administer medication experience,cognitive,capability and total scores increased significantly in intervention group after intervention(Z=-4.525,-4.610,-3.806,-4.718,all P＜ 0.01),while only the cognitive level increased slightly in control group (18 (10,24) vs 13 (11,18),Z =-1.794,P=0.073).Conclusions Follow-up intervention based on WeChat platform can improve the stroke patients' self-administration medication capability,however,the long-term effects on cognitive level and further reform need to be strengthened.