Immune-mediated diseases after vaccinations with AZD1222, BNT-162b2, &/or mRNA-1273: An observational investigation of 78 patients.

BACKGROUND: Immune-mediated diseases (IMDs) after nucleic acid-based vaccines have been sporadically reported since their introduction during the worldwide COVID-19 crisis. Confirming their cause-effect association remains challenging. We analysed the effects of AZD1222 (ChAdOx1 nCoV-19), BNT-162b2, and/or mRNA-1273 on the development &/or deterioration of IMDs in terms of the time of clinical onsets of IMDs after exposure to these vaccines. METHODS: We retrospectively reviewed 78 in-patients in Taipei Veterans General Hospital, who presented with IMDs within 120 days after receiving AZD1222, BNT-162b2, &/or mRNA-1273 vaccinations in Taiwan from May 2021 to April 2022. The duration from inoculation to development of IMD was analysed by two-tailed Kolmogorov-Smirnov (K-S) test for goodness of fit. RESULTS: The average time to new IMDs or flare-up of the diseases following vaccinations was 36 ± 26 days for all 91 events in these 78 patients. The onset time of IMDs after vaccinations was not haphazard as analysed by two-tailed K-S test for overall 91 events (40 new and 51 deteriorating episodes, p < 0.001). The IMDs presenting as non-connective tissue diseases (non-CTDs) have a shorter duration of incubation after vaccinations than those of CTDs (<14.7 days, 95 % confidence interval [CI], 3.0 to 26.4, p = 0.014). Furthermore, systemic vasculitis and type 2 inflammatory diseases were observed exclusively in those receiving AZD1222. CONCLUSION: AZD1222, BNT-162b2, or mRNA-1273 influence the activities of IMDs in ways yet to be explored. High index of suspicion to IMDs after nucleic acid-based vaccine inoculation against COVID-19 may be important for primary care physicians.

Anti-VEGF Therapy Possibly Extends Survival in Patients With Colorectal Brain Metastasis by Protecting Patients From Neurologic Disability.

BACKGROUND: Colorectal brain metastases (CBMs) are rare with poor prognosis. There is still no standard systemic treatment for multiple or unresectable CBM. our study aimed to explore the impact of anti-VEGF therapy on overall survival, brain-specific disease control, and neurologic symptom burden in patients with CBM. METHODS: A total of 65 patients with CBM under treatment were retrospectively enrolled and divided into anti-VEGF based systemic therapy or non-anti-VEGF based therapy. A total of 25 patients who received at least 3 cycles of anti-VEGF agent and 40 patients without anti-VEGF therapy were analyzed by endpoints of overall survival (OS), progression-free survival (PFS), intracranial PFS (iPFS) and neurogenic event-free survival (nEFS). Gene expression in paired primary metastatic colorectal cancer (mCRC), liver, lung and brain metastasis from NCBI data was analyzed using top Gene Ontology (GO) and cBioPortal. RESULTS: Patients who treated with anti-VEGF therapy had significantly longer OS (19.5 vs. 5.5 months, P = .009), iPFS (14.6 vs. 4.1 months, P < .001) and nEFS (17.6 vs. 4.4 months, P < .001). Patients who received anti-VEGF therapy beyond any disease progression presented with superior OS (19.7 vs. 9.4 months, P = .039). Top GO and cBioPortal analysis revealed a stronger molecular function of angiogenesis in intracranial metastasis. CONCLUSIONS: Anti-VEGF based systemic therapy showed favorable efficacy that was reflected in longer overall survival, iPFS and NEFS in patients with CBM.

Analysis of morphometric changes in the anterior alveolar bone in bimaxillary protrusion adult patients after retraction with cone-beam CT / 中华口腔医学杂志

Objective: To measure and analyze the morphometric changes in the anterior alveolar bone during treatment and retention stage after retraction in bimaxillary adults using cone-beam CT(CBCT). Methods: Fifteen adult patients, four males and 11 females, aged 19 to 28 years[(22.2±3.1) years], who have completed orthodontic treatment and extracted four first premolar teeth for retraction in the Department of Orthodontics, The Affiliated Stomatological Hospital of Nanchang University from January 2016 to December 2018 were selected. CBCT was taken to assess the labial and palatal vertical bone level, total bone thickness at crest area, middle root area and apical area in pre-treatment (T1), post-treatment (T2) and at follow-up (maintained for more than two years) (T3). The differences in alveolar bone morphology at different stages were compared by single factor repeated measure ANOVA, and Pearson correlation analysis was performed on the amount of alveolar bone change in treatment stage and retention stage. Results: There were statistically significant differences in the alveolar bone height of the palatal side of maxillary anterior teeth, the labial side of maxillary lateral incisors and canine among three time points (P<0.05). The height difference of palatal alveolar bone of anterior teeth in T1-T2 stage was statistically significant (P<0.05). Palatal alveolar bone of upper and lower central incisors decreased by (1.52±0.32) and (4.96±0.46) mm, respectively. The height difference of anterior palatal alveolar bone was statistically significant in T2-T3 stage(P<0.05), the palatal alveolar bone height of central incisors increased by (1.20±0.27) and (3.14±0.35) mm respectively. The height difference of palatal alveolar bone in the anterior teeth of T1-T3 stage was statistically significant (P<0.05), and the height of palatal alveolar bone of central incisors was decreased (0.33±0.11) and (1.82±0.39) mm, respectively. There were statistically significant differences in the thickness of the cervical and middle root alveolar bone of anterior teeth among three time points (P<0.05). The difference of alveolar bone thickness of the cervical and middle root of anterior teeth at T1-T2 was statistically significant (P<0.05). decreased by (0.63±0.10) and (0.67±0.09) mm in lateral incisors, respectively. In the T2-T3 stage, the alveolar bone thickness of the crest area of the lower anterior teeth was significantly different (P<0.05), the alveolar bone thickness of mandibular central incisor crest area increased (0.09±0.03) mm. There were statistically significant differences in alveolar bone thickness in crest area and middle root of the incisors during T1-T3 stage (P<0.05), among which the middle root decreased by (0.38±0.16) mm and (0.63±0.13) mm, respectively. There was no statistically significant difference in other areas (P>0.05). The change of alveolar bone height in palatal side of upper anterior teeth at T2-T3 was very strongly negatively correlated with the change in T1-T2. The change of alveolar bone height in labial side of upper anterior teeth and lingual side of lower anterior teeth and the thickness of incisor root and neck were moderately strongly negatively correlated (r≤-0.8, P<0.001), the change of alveolar bone height in labial side of upper anterior teeth and lingual side of lower anterior teeth and the thickness of incisor crest area were moderately strongly negatively correlated (-0.8<r≤-0.4, P<0.05). Conclusions: For adult patients after retraction, anterior alveolar bone decreased significantly. In the retention stage, the same degree of bone apposition will occur, but still have alveolar bone loss compared with pre-treatment. The amount of alveolar bone change in the retention stage correlated with the amount of alveolar bone change in the treatment stage.

Deep learning-based de novo drug design: principles, tools and practice / 药学学报

Design of structurally-novel drug molecules with deep learning can overcome the technical bottleneck of classical computer-aided drug design. It has become the frontier of new technique research on drug design, and has shown great potential in drug research and development practice. This review starts from the basic principles of deep learning-driven de novo drug design, goes on with the brief introduction to deep molecular generation techniques as well as computational tools and the analysis on representative successful cases, and eventually provides our perspective for future direction and application prospect about this technique. This review will provide ideas on new technique research and references for new drug research and development practice to which this technique is applied.

Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly (version 2023) / 中华创伤杂志

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Guidelines for management of pediatric acute hyperextension spinal cord injury / 中华创伤杂志(英文版)

Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.

Historical Evolution and Herbal Textual Research of Jupi Zhurutang / 中国实验方剂学杂志

Jupi Zhurutang originated from Synopsis of the Golden Chamber （《金匮要略》）， which consists of Pericarpium Citri Reticulatae， Caulis Bambusae in Taenia， Ginseng Radix et Rhizoma， Zingiberis Rhizoma Recens， Jujubae Fructus， and Glycyrrhizae Radix et Rhizoma and is used to treat retching. It has been put on the list of Catalogue of Ancient Classical Prescription （First Batch） released by National Administration of Traditional Chinese Medicine. With the bibliometric method， we searched the medical classics containing Jupi Zhurutang and systematically examined the information on the origin of the prescription， the indications， compatibility rule， medicinals in the prescription， dosage and usage， processing method， and decocting method. It was found that there are many versions of Jupi Zhurutang， and there are common grounds of main symptoms， pathogenesis， composition and dosage between the same prescription with different names and different prescriptions with the same name. The prescription which is closest to the original version in Synopsis of the Golden Chamber is mainly used for the treatment of stomach deficiency and qi counterflow without obvious cold or heat. According to the weights and measures， ratio of Pericarpium Citri Reticulatae， Caulis Bambusae in Taenia， Radix Ginseng， Rhizoma Zingiberis Recens， and Radix Ginseng in Synopsis of the Golden Chamber is approximately 6∶2∶8∶5∶1. The Jupi Zhurutang derived from other ancient classics such as Yanshi Jisheng Fang（《严氏济生方》） is a different prescription for hiccups caused by the stomach heat， and the ratio of Pericarpium Citri Reticulatae to Caulis Bambusae in Taenia in this prescription is about 1∶1. It is also found that cold herbs such as Red Poria， Eriobotryae Folium and Ophiopogon Japonicus are added to the formula in later generations. Therefore， the Jupi Zhurutang used in modern times is mostly modified and different from that in Synopsis of the Golden Chamber. This study summarizes the historical evolution of Jupi Zhurutang and identifies the key information， with a view to providing a reference for the rational modification of this prescription in clinical settings and further research.

Progress and challenges in RET-targeted cancer therapy / 医学前沿

The rearranged during transfection (RET) is a receptor protein tyrosine kinase. Oncogenic RET fusions or mutations are found most often in non-small cell lung cancer (NSCLC) and in thyroid cancer, but also increasingly in various types of cancers at low rates. In the last few years, two potent and selective RET protein tyrosine kinase inhibitors (TKIs), pralsetinib (BLU-667) and selpercatinib (LOXO-292, LY3527723) were developed and received regulatory approval. Although pralsetinib and selpercatinib gave high overall response rates (ORRs), < 10% of patients achieved a complete response (CR). The RET TKI-tolerated residual tumors inevitably develop resistance by secondary target mutations, acquired alternative oncogenes, or MET amplification. RET G810 mutations located at the kinase solvent front site were identified as the major on-target mechanism of acquired resistance to both selpercatinib and pralsetinib. Several next-generation of RET TKIs capable of inhibiting the selpercatinib/pralsetinib-resistant RET mutants have progressed to clinical trials. However, it is likely that new TKI-adapted RET mutations will emerge to cause resistance to these next-generation of RET TKIs. Solving the problem requires a better understanding of the multiple mechanisms that support the RET TKI-tolerated persisters to identify a converging point of vulnerability to devise an effective co-treatment to eliminate the residual tumors.

Diagnosis and treatment of Shwachman-Diamond syndrome in Chinese children: An evidence-based study / 中华医学遗传学杂志

OBJECTIVE@#To explore the characteristics of Shwachman-Diamond syndrome (SDS) in Chinese children in order to provide a reference for early diagnosis.@*METHODS@#With Shwachman-Diamond syndrome, SDS, SBDS gene and inherited bone marrow failure as the keywords, the search period was set from January 2002 to October 2022. Relevant literature was retrieved from the Wanfang Database and China National Knowledge Infrastructure (CNKI) database. In addition, by using Shwachman-diamond syndrome as a keyword, the search period was also retrieved from the Web of Science, PubMed, and MEDLINE databases from January 2002 to October 2022. A child with SDS treated at the Tongji Hospital was also included. A total of 44 cases with complete clinical data were analyzed with reference to the International Standard for SDS Diagnosis. Chi-square test and t test were used for statistical analysis. Evidence-based research was carried out in the form of systematic review. The epidemiology, clinical characteristics and key points of early diagnosis of the Chinese SDS children were summarized and compared with the international data.@*RESULTS@#The main characteristics of SDS in Chinese children were summarized as follows: The ratio of males to females was about 1.3 : 1, the median age of onset was 3 months, and the median age of diagnosis was 14 months. The first symptoms were often exocrine pancreatic insufficiency (31.8%) and granulocytopenia with infection (31.8%). According to the international consensus, the incidence rates of the three major diseases of SDS were hemocytopenia (95.4%), pancreatic disease (72.7%), and bone abnormality (40.9%). The common factors underlying SDS disease were variants of the SBDS gene (c.258+2T>C and c.183_184TA>CT), albeit there was no significant correlation between genotype and phenotype (P > 0.05). Compared with international reports, the clinical manifestations and genotypes of Chinese SDS children are different (P < 0.05).@*CONCLUSION@#The SDS children have an early age of onset and significant individual difference. It is necessary to analyze the case-related data to facilitate early recognition, diagnosis and clinical intervention.

Fostering Green Innovation Adoption through Green Dynamic Capability: The Moderating Role of Environmental Dynamism and Big Data Analytic Capability.

Though the concept of green dynamic capability has been increasingly gaining traction among academics, practitioners, and policymakers, its association with green innovation adoption remains unclear. The present study addresses this gap and aims to provide clarity by distinguishing green innovation adoption in the context of developing countries. Drawing on dynamic capability and stakeholder theory, this research shed light on the significance of green dynamic capability for green innovation adoption. Additionally, this study examines the moderating role of environmental dynamism and big data analytics capability in the link between green dynamic capability and green innovation adoption. Adopting a two-wave research design, the sample for this study contained SMEs from Pakistan and Malaysia. Data was obtained from 220 SMEs (105 from Pakistan, 115 from Malaysia). To test the hypotheses, covariance-based structural equation modelling was performed to analyze causal relationships in the model, by using AMOS 23 software. The results showed that green dynamic capability positively impacts green innovation adoption, but environmental dynamism does not positively moderate between green dynamic capability and green innovation adoption. In addition, big data analytics capability positively moderates between green dynamic capability and green innovation adoption. We believe that this study opens a new avenue in the environmental literature under which green innovation adoption is useful for SMEs.

Chyme Reinfusion Reducing the Postoperative Complications After Definitive Surgery for Small Intestinal Enteroatmospheric Fistula: A Cohort Study.

Purpose: This study is aimed to reveal the role of preoperative chyme reinfusion (CR) in reducing the complications occurring after definitive surgery (DS) for small intestinal enteroatmospheric fistula (EAF). Methods: In this study, from January 2012 to December 2019, the patients with small intestinal EAF and receiving a definitive surgery were recruited. Depending on whether the CR has been performed, these patients were divided into either the CR group or the non-CR group. Then, propensity scores matching (PSM) was used to further divide these patients into the PSM CR group or the PSM none-CR group. The clinical characteristics exhibited by the groups were analyzed, and the effect of preoperative CR was investigated. Result: A total of 159 patients were finally recruited with 72 patients in the CR group and 87 patients in the non-CR group. The postoperative complications were manifested in a total of 126 cases (79.3%). There were 49 cases in the CR group, and 77 cases in the non-CR group. CR was associated with the occurrence of postoperative complications (multivariate odds ratio [OR] = 0.289; 95% CI: 0.123-0.733; p = 0.006). After 1:1 PSM, there were 92 patients included. The postoperative complications were observed in 67 out of these 92 patients. There were 26 patients in the PSM CR group, and 41 patients in the PSM non-CR group. CR was associated with postoperative complications (multivariate OR = 0.161; 95% CI: 0.040-0.591; p = 0.002). In addition, CR played a role in reducing the recurrence of fistula both before (multivariate OR = 0.382; 95% CI: 0.174-0.839; p = 0.017) and after (multivariate OR = 0.223; 95% CI: 0.064-0.983; p = 0.034) PSM. In addition, there is a protective factor at play for those patients with postoperative ileus before (multivariate OR = 0.209; 95% CI: 0.095-0.437; p < 0.001) and after (multivariate OR = 0.222; 95% CI: 0.089-0.524; p < 0.001) PSM. However, the relationship between CR and incision-related complications was not observed in this study. Conclusion: Preoperative CR is effective in reducing postoperative complications after definitive surgery was performed for EAF.

Chyme reinfusion improved outcomes after definitive surgery for small-intestinal enteroatmospheric fistula in patients with enteral nutrition.

PURPOSE: In patients suffering from small-intestinal enteroatmospheric fistula who are receiving enteral nutrition (EN), although the function of the small intestine is sufficient, without chyme reinfusion (CR), disuse of the distal intestine of enteroatmospheric fistula may occur. However, CR reverses such pathological changes and have an influence on improving outcomes following definitive surgery (DS) for small-intestinal enteroatmospheric fistula. This study attempted to investigate the effect of preoperative CR in patients with EN on the outcomes after DS for small-intestinal enteroatmospheric fistula. METHODS: According to whether CR was performed between January 2012 and December 2019, patients receiving DS for small intestinal enteroatmospheric fistula were divided into the CR group and non-CR group. The effect of preoperative CR was then investigated. RESULTS: A total of 159 patients were finally enrolled, of which 72 patients were in the CR group and 87 patients were in the non-CR group. A total of 47 (29.56%) patients were found to have recurrent fistula after DS, the recurrent fistula rate in the CR group (multivariate odds ratio = 0.557; 95% CI, 0.351-0.842; P = 0.019) was lower. CR was also shown to promote postoperative recovery of bowel function (hazard ratio [HR] = 1.982; 95% CI, 1.199-3.275; P = 0.008), and shorten postoperative length of stay (LOS) (HR = 1.739; 95% CI, 1.233-2.453; P = 0.002). CONCLUSION: Preoperative CR may reduce the incidence of recurrent fistula, time to return of bowel function and postoperative LOS following DS for small-intestinal enteroatmospheric fistula.

Clinical efficacy of Tuina manipulations for lumbar disc herniation and its influence on posture-associated indicators / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of sinew-bone balancing manipulation in treating lumbar disc herniation (LDH) and offer clinical evidence to support the concept of paying equal attention to sinew and bone. Methods: Sixty LDH patients were randomized into an observation group and a control group, with 30 cases in each group. The observation group was treated with the sinew-bone balancing manipulation, and the control group received conventional Tuina (Chinese therapeutic massage) manipulation. The clinical efficacy and posterior muscle chain tone effect were compared between the two groups by observing the visual analog scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and posture-associated indicators. Results: The total effective rate was 86.7％ in the observation group, higher than 76.7％ in the control group, but the between-group difference in efficacy was statistically insignificant (P>0.05). After treatment, the VAS and JOA scores, angle-dependent muscle tone indicator of the posterior muscle chain, and lumbar posture symmetry showed significant changes in both groups (P<0.05). The VAS and JOA scores, angle-dependent muscle tone indicator of the posterior muscle chain, and lumbar posture symmetry in the observation group were significantly different from those in the control group after treatment (P<0.05), but the between-group difference in the general posture symmetry was statistically insignificant (P>0.05). Conclusion: Both the sinew-bone balancing and conventional Tuina manipulations can reduce pain in LDH patients, improve lumbar function, and adjust the angle-dependent muscle tone coefficient of the posterior muscle chain and lumbar posture symmetry; except for the general posture symmetry of the posterior muscle chain, the sinew-bone balancing manipulation wins out over the conventional Tuina manipulation.

Analysis of microbiota characteristics in tumor tissues sampled under gastroscope / 中华微生物学和免疫学杂志

Objective:To investigate the characteristics of bacterial community in upper gastrointestinal tumors.Methods:The study population was patients with upper gastrointestinal tumors (esophageal cancer and gastric cancer). Gastroscopy was performed on the enrolled patients ( n=17), and the specimens were taken from the tumor sites. At the same time, non-tumor tissues more than 4 cm away from the tumor tissues were taken as the control. After total DNA was extracted and purified, high-throughput 16S DNA gene sequencing was used to detect the microbiota in tumor tissues and control tissues. Bioinformatics analysis was carried out and the differences between groups were compared. Results:16S DNA PCR showed that there was no significant difference in bacterial load between tumor tissues and control tissues. The α-diversity and β-diversity indexes showed that the community composition of the two groups was similar; the samples were discrete and the colony composition was different, but there was no significant difference between the two groups. The results of Venn diagram showed that there were more operational taxonomic units (OTUs) in non-tumor tissues than in tumor tissues (2 068 vs 1 358), indicating that the bacterial species in normal tissues were more abundant than those in tumor tissues. Compared with the control tissues, the percentages of Prevotellaceae ( Prevotella), Lactobacaceae ( Lactobacillus) and Fusobacteriaceae ( Fusobacterium) in tumor tissues were relatively higher (the average percentage was more than twice that of the control). Further paired comparison of the top ten bacteria in the family and genus abundance of the two groups of samples showed that Pseudomonas decreased significantly in tumor tissues at the family ( P=0.041) and genus ( P=0.041) levels, while Prevotella was significantly enriched in tumor tissues at the family ( P=0.031) and genus ( P=0.007) levels. Conclusions:The bacterial community in the tumor microenvironment of the upper gastrointestinal tumor changed, and the species enriched in the tumor site were mainly oral common anaerobic bacteria, such as Prevotellaceae ( Prevotella), Lactobacaceae ( Lactobacillus) and Fusobacteriaceae ( Fusobacterium), especially Prevotellaceae ( Prevotella).

Polyhydroxylated eudesmane sesquiterpenoids and sesquiterpenoid glucoside from the flower buds of Tussilago farfara / 中国天然药物

Chemical fractionation of the n-BuOH partition, which was generated from the EtOH extract of the flower buds of Tussilago farfara, afforded a series of polar constituents including four new sesquiterpenoids (1-4), one new sesquiterpenoid glucoside (5) and one known analogue (6) of the eudesmane type, as well as five known quinic acid derivatives (7-11). Structures of the new compounds were unambiguously characterized by detailed spectroscopic analyses, with their absolute configurations being established by X-ray crystallography, electronic circular dichroism (ECD) calculation and induced ECD experiments. The inhibitory effect of all the isolates against LPS-induced NO production in murine RAW264.7 macrophages was evaluated, with isochlorogenic acid A (7) showing significant inhibitory activity.

Analysis on vaccination willingness and related factors of influenza, pneumonia, and herpes zoster vaccine among people over 50 years old in Minhang district of Shanghai / 中华预防医学杂志

Objective: To determine the knowledge of influenza, pneumonia, herpes zoster and related vaccines, willingness to vaccinate under multiple payment scenarios, and corresponding risk factors among people over 50 years old in Minhang District of Shanghai. Methods: A total of 1 672 respondents aged 50-69 from 13 communities/towns in Minhang district of Shanghai were included in this study using a stratified random sampling strategy on December 2020. The knowledge of influenza, pneumonia, herpes zoster and vaccines was investigated using a questionnaire, and the differences in the willingness under multiple payment scenarios were determined using chi-square test. The consistency in the willingness under multiple payment scenarios was compared using Cohen's Kappa and the risk factors of the willingness was determined using ordinal logistic regression. Results: The average age of 1 672 respondents was (60.48±5.96) years old, including 777 (46.47%) males and 895 (53.53%) females. A total of 1 350 subjects (80.74%) had local household registration in Shanghai. The proportion of the willingness to vaccinate for themselves, spouses, and parents under any payment scenario was determined to be 80.6% (influenza vaccine), 81.5% (pneumonia vaccine), and 74.0% (herpes zoster vaccine). The willingness to vaccinate against influenza and pneumonia under multiple payment scenarios remained stable (Kappa value ≥0.6), while that against herpes zoster infection was inconsistent (Kappa value ≤0.35). Logistic regression analysis showed that respondents who had higher knowledge of influenza and influenza vaccine [OR (95%CI): 1.111 (1.054-1.170), 1.182 (1.126-1.240), respectively], aged 50-59 [1.305 (1.085-1.531)] and local household registration in Shanghai [1.372 (1.079-1.721)] had higher willingness to vaccinate against influenza, while males had lower willingness [0.733 (0.551-0.910)]. Respondents who had higher knowledge of pneumonia and pneumonia vaccine [OR (95%CI): 1.837 (1.152-2.517), 2.217 (1.541-2.893), respectively] had higher willingness to receive pneumonia vaccine. Respondents aged 50-59 [1.327 (1.059-1.537)] and with local household registration in Shanghai [2.497 (1.417-4.400)] were more likely to be vaccinated against herpes zoster, while those with middle school degree or below [0.664 (0.396-0.992)] and high school degree [0.559 (0.324-0.964)] were less likely to be vaccinated. Conclusion: Among people aged over 50 years old in Minhang district of Shanghai, the willingness to vaccinate for themselves, spouses, and parents against influenza, pneumonia and herpes zoster infection is quite different under multiple payment scenarios, especially for herpes zoster vaccine.

Q-marker prediction analysis of Gentiana rigescens Franch. based on HPLC and network pharmacology / 药学学报

Aa a characteristic medicinal plant in China, Gentiana rigescens Franch. has the function of protecting the liver and invigorating the spleen. At present, there are a few studies on the content determination method of characteristic components of G. rigescens, so it is necessary to establish a scientific and effective quality control method; In this study, The high performance liquid chromatography (HPLC) fingerprint of G. rigescens was established, based on literature reviewed and characteristic spectrum identified, the source range of G. rigescens quality marker (Q-marker) was screened. The effectiveness of the ingredients and the corresponding targets and pathways was analyzed through network pharmacology, and drew the diagram of ''component-target-pathway''. Qualitative and quantitative analysis of G. rigescens was performed by HPLC, and screen the main marker components leading to the differences between groups which were determined the Q-marker of G. rigescens; The literature and HPLC had determined that five iridoids were the main source of G. rigescens Q-marker. The network pharmacology (effectiveness) and qualitative and quantitative (detectability) analysis of G. rigescens from different producing areas confirmed that gentiopicroside, swertiamarin, and sweroside can be used as the main landmark components, and there were significant differences in their contents among different producing areas; The analysis of G. rigescens from different producing areas was carried out by network pharmacology and chemical fingerprints, it is confirmed can be used as potential Q-marker to provide sufficient theoretical basis for the quality control of G. rigescens in the later period.

Discussion on Treatment of Recurrent Genital Herpes with Zhulingtang： Based on Thought of "Lower Energizer Resembling Drainage" / 中国实验方剂学杂志

Recurrent genital herpes is a sexually transmitted disease induced by herpes simplex virus（HSV）， mainly manifested as erythema， papules， vesicles， erosion， and exudation on the skin and mucosal membranes of the genital and anal area， accompanied by burning pain， or tingling. Factors leading to its recurrence are overworking， fever， alcohol consumption， infection， sexual activity， etc. At least 1 in 10 of the 15-49-year-old population are infected with herpes simplex virus-2. There is currently no available method to completely remove the herpes simplex virus and prevent its recurrence， and recurrence seriously affects the quality of life and psychological health of patients. According to the theory of traditional Chinese medicine （TCM）， the recurrence of genital herpes is mostly related to wind， dampness， heat， yin deficiency of liver and kidney， internal injuries due to emotional disorder， and dietary preference. TCM has advantages in reducing its recurrence rate. The lower energizer is closely related to skin diseases， and "lower energizer resembles drainage". Thus， the lower energizer is closely related to water and damp metabolism. Recurrent genital herpes occurs in the lower energizer and belongs to lower energizer diseases， and the fluid metabolism and qi movement in lower energizer are closely related to the occurrence of the disease. Based on thought of "lower energizer resembling drainage" and the clinical characteristics of recurrent genital herpes， this paper considered malfunction of lower energizer as its pathogenesis. Thus， smoothing the lower energizer according to the prevailing circumstances is particularly important and the treatment principle should be dispersing the pathogen from lower energizer without damaging yin. Zhulingtang （Treatise on Cold Damage and Miscellaneous Diseases） cures the difficulty in urination and thirst with desire to drink by smoothing the lower energizer. Thus， Zhulingtang was selected to treat recurrent genital herpes. This study is expected to provide a new idea for its clinical diagnosis and treatment.

Psychological experience of blood donors with blood donation-related vasovagal reaction: a qualitative research / 中国输血杂志

【Objective】 To explore the psychological experience of blood donors with blood donation-related vasovagal reaction (DRVR), so as to provide basis for improving the quality of blood donation services. 【Methods】 The real experience of 9 DRVR blood donors was analyzed using the phenomenological research method in qualitative research. 【Results】 The occurrence of DRVR caused distinct psychological conflict among blood donor. Blood donors lacked knowledge about blood donation and expected professional evaluation and continuous support. The occurrence of DRVR was an important reason for blood donor lapsing. 【Conclusion】 By resolving the distinct psychological conflicts of DRVR blood donors, establishing DRVR early warning evaluation and feedback system, as well as strengthening the construction of support system, blood collection and supply institutions can create a good humanistic and social environment for sustainable development of voluntary blood donation.

SPRC Suppresses Experimental Periodontitis by Modulating Th17/Treg Imbalance.

Object: The aims of the study were to explore the protective effects of S-propargyl-cysteine (SPRC) on periodontitis and to determine the underlying mechanisms. Methods: A rat periodontitis model was constructed by injecting LPS and SPRC (0, 25, and 50 mg/kg/d) was administered intraperitoneally. H2S and CSE level were detected. The alveolar bone level was evaluated by micro-CT, HE staining and methylene blue staining analysis. Inflammation-related factors, Treg and Th17 cells were detected by immunohistochemistry, RT-PCR, immunofluorescence, Western blot and flow cytometry. Phosphorylation levels of ERK1/2 and CREB were analysed. Results: The administration of SPRC significantly increased the expression of CSE in the gingival tissue and the concentration of endogenous H2S in the peripheral blood. Simultaneously, SPRC significantly inhibited the resorption of alveolar bone based on the H&E staining, micro-CT and methylene blue staining analysis. Compared with the periodontitis group, the levels of IL-17A, IL-10 were downregulated and IL-6,TGF-ß1 were upregulated in the SPRC groups. In the SPRC group, the percentage of TH17 cells and the expression of ROR-γt were downregulated, while the percentage of Tregs and the expression of Foxp3 were upregulated accompanied with inhibition of phosphorylation ERK1/2 and CREB. Conclusion: SPRC can prevent the progression of periodontitis by regulating the Th17/Treg balance by inhibition of the ERK/CREB signalling pathway.