Objective To establish an objective method for evaluating the intrinsic characteristics between cold and hot nature of Chinese materia medica(CMM)through the different effects of Mahuang decoction(MHD)and Maxing Shigan decoction(MSD)on animal temperature tropism.Methods The equipment with cold/hot pads was used to investigate the variety ofthe temperature tropism between two groups of mice treated by MHD and MSD,respectively.Meanwhile,the activities ofadenosine triphosphatase(ATPase),superoxide dismutase,succinate dehydrogenase,and malondialdehyde were measured.Results After treated by MHD,the macroscopic behavioral index of remaining rate on warm pad(40 ℃)of mice decreasedsignificantly(P < 0.05),suggesting the enhancement of cold tropism,meanwhile,the internal indices of ATPase activity and oxygen consuming volume increased significantly(P < 0.05),suggesting the enhancement of energy metabolism.On theother hand,the above-mentioned indices in MSD group changed on the inverse way.Conclusion The relative drug natureof MHD and MSD revealed in this study is consistent with the theoretical prognostication or definition.It indicates that theinternal cold and hot nature of CMM could be reflected in ethological way on the changes of animal temperature tropismwhich might be internally regulated by body energy metabolism.

Irritable bowel syndrome (IBS) is characterized by abdominal pain associated with changes in defecation frequency and blood folate level. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. High-FODMAP diet could elicit or exacerbate IBS-associated bowel symptoms, which is inadequately recognized among gastroenterologists in China. Here we report an IBS case, focusing on the association between high-FODMAP diet and bowel symptoms and the intervention of low-FODMAP diet.

Objective : To analyze the overall survival( OS) of sequential osimertinib treatment in patients with epidermal growth factor receptor(EGFR) exon 20 T790M mutant advanced non⁃small cell lung cancer(NSCLC) and risk factors of the efficacy of sequential osimertinib treatment. Methods : The data of 138 advanced NSCLC patients with acquired EGFR exon 20 T790M mutation who took sequential osimertinib as second⁃line treatment. KaplanMeier variable was used for survival analysis. The Log⁃rank method was used for univariate analysis. The COX risk regression model was used for multivariate analysis. The survival status and influencing factors of patients treated with sequential osimertinib were analyzed. Results : At the last follow⁃up , 99 of the 138 patients died. Median progression free survival (PFS1)of first⁃line of first⁃ or second⁃generation epidermal growth factor receptor tyrosine kinase inhibitors(EGFR⁃TKIs) was 11 months (95% CI: 10. 1 - 11. 9) ; median PFS2 of osimertinib was 10 months (95% CI: 8. 5 - 11. 5) ; The median PFS with sequential osimertinib treatment was 24 months(95% CI: 21. 7 -26. 3) , the median OS was 32 months(95% CI: 28. 9 - 35. 1) . In univariate and multivariate analysis , PFS1 was an independent prognostic factor for PFS and OS(P < 0. 001) . Conclusion Sequential osimertinib treatment for advanced NSCLC patients with acquired EGFR exon 20 T790M mutation achieved good PFS(24 months) and OS (32 months) .