This article believed that natural medicine resources in the Three Gorges Reservoir Area are abundant and with modern industrialization development basis through analysis of condition, distribution features and development prospect of natural medicine resources. It argued that natural medicine resources can be the industry with the most sustainable development potential in the Three Gorges Reservoir Area and the efficient path to solve industrial hollowing and surplus labors after immigrants of the area, which can greatly improve and optimize environment of the area. It proposed that the development of natural medicine resources should be closely combined with strong pharmaceutical enterprises;innovation and research centers for natural medicine resources in the area should be established;professional wholesale markets should be built;strong varieties should be developed;standardized quality control system should be set up. All the above mentioned are with the purpose to promote industry standardization and science, and provide references for government rational development and utilization of natural medicine resources.

OBJECTIVE:To provide reference for improving the policies and countermeasures for national essential medicines. METHODS:The existing problems of medicine distribution under essential medicine system were analyzed and countermeasures were put forward. RESULTS:Due to the regional economic environment and industry development level differences,local policy had conflict with national laws and regulations,lacking of systembasis in regulatory process and drug centralized bidding and pur-chasing department weakened responsibility in terms of administrative supervision when performing national essential medicine sys-tem;distribution distribution capability had weakened,distribution enterprise internal management was not standard,the essential medicine storage and distribution process quality showed safety hidden risks in terms of marketization. It is suggested to establish and improve the national essential medicine system overall implementation programs and regional implementation programs,inte-grate medicine distribution market,explore and establish modernized pharmaceutical logistics system,intensify supervision and management of distribution,support distvibution transformation development to reduce social risk and further improve bidding and purchasing mechanism to reduce distribution costs. CONCLUSIONS:The existing problems in distribution can be gradually solved only by further promoting the medical and health system and improving the national essential medicine system.

OBJECTIVE:To compare the contents of osthole and columbianadin in Argelica. pubescens in Wushan county, Wuxi county in Chongqing and other domestic areas in china. METHODS:HPLC was performed on the column of Shiseido Cap-cell Pak C18 with mobile phase of acetonitrile-water(gradient elution) at flow rate of 1.0 ml/min,detection wavelength was 330 nm,column temperature was 30 ℃ and volume injection was 10 μl. RESULTS:The linear range was 0.015 1-0.301 6 mg/ml(r=0.999 9) for osthole and 0.016 7-0.334 4 mg/ml(r=0.999 9) for columbianadin;RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 98.46%-106.11%(RSD=2.34%,n=9)and 98.24%-102.69%(RSD=1.29%,n=9), respectively. CONCLUSIONS:The method is simple and good reproducibility,and and can be used for the contents determination of osthole and columbianadin in A. pubescens. The contents of osthole and columbianadin in A. pubescens of Wushan county in Chongqing are obviously higher than Wuxi county and other domestic areas in China.

OBJECTIVE:To establish a method for the identification of Chongqing local medicinal material Heracleum hemsley-anum. METHODS:The original plant morphology,morphological characteristics,microscopic characteristics (transverse section and powder),were identified. RESULTS:H. hemsleyanum had cone shape root,brown,many-branched with special fragrance;the microscopic characteristics of taproot a transverse showed no differences with lateral root transverse section,primary xylem was di-arch,secondary phloem was more developed than secondary xylem,secondary phloem was rich in the oil chamber. Vascular tissues contained a large number of parenchyma cells. In TLC chromatrogram,the test sample showed the same color fluorescent spots with-the substance reference of osthole and columbianadin in the corresponding locations. CONCLUSIONS:The established method is simple with high accuracy,and can be used as the basis for identification of H. hemsleyanum.

OBJECTIVE:To improve the effectiveness of experimental teaching and independent hands-on ability of the students.METHODS:Combined with teaching characteristics of newly established universities,the characteristics of instrumental analytical experiment teaching and the characteristics of pharmaceutical students,flipped classroom and project modular design were applied to instrumental analytical experiment teaching together.The instrumental analytical experiment teaching was expounded and integrated in respects of curriculum content design,teaching implementation and curriculum assessment.RESULTS&CONCLUSIONS:The students achieve the knowledge learning after classroom,and complete the knowledge absorption and mastering in class with the help of video and audio information.It also improved independent learning ability of the students,strengthened the ability of interactive learning and cooperative leafing between teachers and students and among students.It is feasible to apply the flipped classroom and the experimental project modular design in the instrument analytical chemistry experiment teaching reform.This method also can provide some references for the reform of instrument analytical chemistry experiment teaching.

OBJECTIVE:To put forward suggestions for improving the supervision of phase Ⅳ clinical trials in China. METH-ODS:According to summarizing the post-marketing research in America,FDA's supervision(including key elements,supervision flow,auxiliary supervision system and enforcement measures)for drug post-marketing research in America was analyzed,and sug-gestions for the supervision of phaseⅣclinical trials in China was put forward. RESULTS&CONCLUSIONS:The drug post-mar-keting research in America included post-marketing commitment research(PMR)and post-marketing requirement research(PMC). The key elements included supervision subjects(dealt by Office of New Drugs affiliated to Drug Evaluation and Research Center), key document (including the documents helping FDA and applicants reached a research agreement,and documents for process tracking and supervision in identified studies)and important time node. The supervision flow included developing drafts and review-ing reports. FDA had established PMC/PMR database,which was used as auxiliary supervision system,and relevant enforcement measures were respectively developed for PMC and PMR. Relevant supervision departments in China should converse the supervi-sion ideas,give full play to the government's guidance and supervision,enhance the connection of supervision between pre- and post-marketing,specially develop phase Ⅳ clinical program,establish system for phase Ⅳ clinical trial data,enhance whole pro-cess supervision,draw lessons from"pre-process plan,dynamic tracking in the process,and post-process decision according to law"of FDA to improve the supervision of phaseⅣclinical trials in China.

Objective:To explore the incremental value of subtraction technique in evaluating the major features of liver reporting and data system version 2018 (LI-RADS v2018) on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI.Methods:The Gd-EOB-DTPA enhanced MRI of 117 pathologically verified hepatocellualr carcinoma(HCC) from 87 high-risk patients in Henan Provincial People′s Hospital from January 2019 to July 2020 was analyzed retrospectively. The major features of LI-RADS in arterial phase, portal venous phase, subtraction and combined images were evaluated including nonrim arterial phase hyperenhancement (Nonrim APHE), nonperipheral washout and enhancing capsule. The lesions were graded according to LI-RADS v2018. According to the lesion size (<20 mm, ≥20 mm) and T 1WI signal intensity (hypointensity, isointensity or hyperintensity), the patients were divided into different subgroups. Cochran′s Q test was used for the comparison of the detection rate of the major features of LI-RADS and the accurate diagnosis rate based on LR-5 as the diagnostic standard among multiple groups. McNemar test was used for the comparison between two groups. Results:For all HCC, hypointensity HCC and HCC ≥20 mm, the detection rate of Nonrim APHE (χ2=12.190, 12.500, 10.083, all P<0.001) and the accurate diagnosis rate of HCC (χ2=14.450, 12.500, 10.083, all P<0.001) of subtraction images from arterial phase were significantly higher than that of arterial images. For HCC<20 mm, the detection rate of Nonrim APHE combined with arterial phase images was significantly higher than that in arterial phase images (χ2=5.143, P=0.016). For all HCC and isointensity or hyperintensity HCC, the detection rate of nonperipheral washout combined with portal venous phase images was higher than that in portal venous phase images (χ2=7.111, 6.125, P=0.004, 0.008). The detection rate of enhancing capsule of subtraction images from portal venous phase was higher than that of portal venous phase images in all groups (all P<0.017). The accurate diagnosis rate of subtraction images from portal venous phase in all HCC and HCC≥20 mm was higher than that in portal venous phase images (χ2=6.722, 6.750, P=0.008, 0.006). The accurate diagnosis rate of LR-5 in all groups using subtraction images from arterial phase and portal venous phase was higher than that of MRI images (all P<0.013). Conclusion:For Gd-EOB-DTPA dynamic enhanced MRI, subtraction images from arterial phase and portal venous phase are better than arterial phase and portal venous phase images in displaying Nonrim APHE, nonperipheral washout and enhancing capsule, which can improve the LI-RADS classification of HCC.

Objective:To investigate the value of serum miR-143 level combined with MRI in predicting the early response to concurrent chemoradiotherapy (CCRT) in cervical cancer.Methods:A total of 85 patients with pathologically confirmed cervical cancer underwent conventional MRI, intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), and dynamic contrast-enhanced MRI (DCE-MRI) before CCRT. The biopsy tissues and serum samples were collected. The differential expression of miRNA in the biopsy tissues was determined by microarray chip. The expression level of miR-143 in the serum samples was analyzed by qRT-PCR. All patients were divided into the non-residual and residual tumor groups according to post-treatment MRI. Pre-treatment clinical factors, MRI parameters and miR-143 between two groups were statistically analyzed by the univariate and multivariate analyses. The optimal thresholds and predictive performance for post-treatment incidence of residual tumors were estimated by drawing the ROC curve.Results:At one month after CCRT, there were 52 patients in the non-residual tumor group and 33 patients in the residual tumor group. In the residual tumor group, pre-treatment FIGO staging, apparent diffusion coefficient (ADC), D and V e were significantly higher (all P<0.05), whereas K trans value was significantly lower ( P<0.001) when compared to those in the non-residual tumor group. The miRNA array analysis showed that there were 16 miRNAs with differential expression levels between two groups (all P<0.05). Among them, the increase of miR-143 was the most significant in the residual tumor group. Compared with the residual tumor group, the expression level of serum miR-143 was significantly down-regulated in the non-residual tumor group ( P=0.002). Compared with the SiHa cells, the expression level of miR-143 in the SiHa-R cells was significantly up-regulated ( P<0.05). Multivariate analysis showed that only miR-143, D, K trans and V e were the independent prognostic factors. The combination of multi-parametric MRI and miR-143 exhibited the highest predictive performance (AUC=0.975), with a sensitivity of 84.8% and a specificity of 96.2%. Conclusion:The combination of multi-parametric MRI with miR-143 further improves the predictive performance for residual tumors after CCRT, which contributes to the personalized treatment of cervical cancer.

BACKGROUNDThe diagnosis of liver fibrosis is a difficult task at any time using conventional clinical imaging. Intravoxel incoherent motion (IVIM) can be used to investigate both diffusion and perfusion changes in tissues. This study was designed to determine the value of IVIM in the diagnosis and staging of liver fibrosis.

METHODSIVIM examinations were performed on a GE 3.0T MR scanner in 25 patients with liver fibrosis and 25 healthy volunteers as the control group. Patients with liver fibrosis diagnosis were confirmed by pathology and staged on a scale of F0-4. The standard ADC values and the values of a biexponential model (slow ADC (Dslow), fast ADC (Dfast) and fraction of fast ADC (FF)) were measured in three liver regions per person. The mean standard ADC values, Dslow values, Dfast values and FF values from the study group were compared among the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Receiver Operating Characteristic (ROC) curves and independent-samples t-tests were used to calculate the mean standard ADC values, Dslow values, Dfast values and FF values from the study group and the control group. Spearman rho correlation analysis was used for the stage of liver fibrosis. The liver fibrosis stages between the groups F0-1 and F2-4, the groups F0-2 and F3-4 were compared.

RESULTSAmong the liver fibrosis, there was no significant difference in the mean standard ADC values, Dslow values, Dfast values, and FF values obtained from the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Using ROC analysis, the Area Under the Curve (AUC) values of standard ADC, Dslow, Dfast, FF were all between 0.7 to 0.9. The mean standard ADC values, Dslow values, Dfast values and FF values of the liver in the study group were significantly lower than the values in the control group (P < 0.05). As the stage of the fibrosis increased, the values decreased by Spearman rho correlation analysis. The mean values (standard ADC, Dslow, Dfast, and FF) of liver fibrosis stages between the groups F0-1 and F2-4, the groups F0-2 and F3-4 showed significant differences (P < 0.05).

CONCLUSIONSIVIM can reflect the conditions of perfusion and diffusion in liver fibrosis and thus distinguish between normal liver and liver fibrosis. The IVIM technique may serve as a valuable tool for detecting and characterizing liver fibrosis, and monitoring its progression in a noninvasive manner.

Adult ; Aged ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; Male ; Middle Aged

To scientifically evaluate the intervention effect of Chinese medicine preventive administration(combined use of Huo-xiang Zhengqi Oral Liquid and Jinhao Jiere Granules) on community population in the case of coronavirus disease 2019(COVID-19), a large cohort, prospective, randomized, and parallel-controlled clinical study was conducted. Total 22 065 subjects were included and randomly divided into 2 groups. The non-intervention group was given health guidance only, while the traditional Chinese medicine(TCM) intervention group was given two coordinated TCM in addition to health guidance. The medical instructions were as follows. Huoxiang Zhengqi Oral Liquid: oral before meals, 10 mL/time, 2 times/day, a course of 5 days. Jinhao Jiere Granules: dissolve in boiling water and take after meals, 8 g/time, 2 times/day, a course of 5 days, followed up for 14 days, respectively. The study found that with the intake of medication, the incidence rate of TCM intervention group was basically maintained at a low and continuous stable level(0.01%-0.02%), while the non-intervention group showed an overall trend of continuous growth(0.02%-0.18%) from 3 to 14 days. No suspected or confirmed COVID-19 case occurred in either group. There were 2 cases of colds in the TCM intervention group and 26 cases in the non-intervention group. The incidence of colds in the TCM intervention group was significantly lower(P<0.05) than that in the non-intervention group. In the population of 16-60 years old, the incidence rate of non-intervention and intervention groups were 0.01% and 0.25%, respectively. The difference of colds incidence between the two groups was statistically significant(P<0.05). In the population older than 60 years old, they were 0.04% and 0.21%, respectively. The incidence of colds in the non-intervention group was higher than that in the intervention group, but not reaching statistical difference. The protection rate of TCM for the whole population was 91.8%, especially for the population of age 16-60(95.0%). It was suggested that TCM intervention(combined use of Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules) could effectively protect community residents against respiratory diseases, such as colds, which was worthy of promotion in the community. In addition, in terms of safety, the incidence of adverse events and adverse reactions in the TCM intervention group was relatively low, which was basically consistent with the drug instructions.
Adolescent ; Adult ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pandemics ; Pneumonia, Viral ; drug therapy ; Prospective Studies ; Young Adult