Objective To elucidate potential activities of phthalides and terpenoids from Angelica sinensis by theoreticaldocking calculation.Methods Eleven components of phthalides and terpenoids were selected as ligand.Thecrystalline structures of targets related to common diseases were used as the receptors for calculation.Thecalculations were conducted with Schr(o)dinger software package.The grading standard of selectivity was developedaccording to G-score between ligands and receptors.Results Selective targets of phthalides and terpenoids wererelated to nevous system diseases,cancer,pain,diabetes,cardiovascular disease,liver cirrhosis,nephrotic syndrome,inflammatory diseases,rheumatoid arthritis,dermatosis,leukemia,microbial inflections,immune diseases,andhypercholesterolemia.In addition to the medical treatments reported in the literature,our research also indicated thatthese two classes of compounds may be used for tumor,diabetes,rheumatoid arthritis,dermatosis,leukemia,livercirrhosis,and nephrotic syndrome.According to our research,the effects of phthalides and terpenoids may be not sostrong.Conclusion The effects of phthalides and terpenoids on diseases founded through virtual evaluation accord greatly with those reported in experiment and clinic.The combination of computer-aided drug evaluation technique and experiment is definitely an important and fast way to investigate the effects and mechanisms of traditional Chinese medicine.

Background and purpose: Since the detection of renal neoplasm is increasing, it's important to distinguish myomatous angiomyolipoma (mAML) from malignant tumors. This study aimed to investigate the imaging features of renal mAML on computer tomography (CT) and improve the accuracy of diagnosis and differential diagnosis. Methods: Ten patients were diagnosed with mAML. The cases were composed of 4 men and 6 women, with a mean age of 53.2 years (range 38-64). Among all of the cases, the percentage of spindle cell is more than 70%. Two radiologists reviewed all of the images to evaluate general characteristics, imaging features on unenhanced CT and enhanced CT. The mean attenuation on the unenhanced CT of mAML, normal renal parenchyma and skeletal muscle was compared by the paired-sample t test. Results: Among all of the tumors, nine lesions were solitary, and the other one was accompanied with typical AML. Six lesions were at the left kidney while four lesions were at the right side. Five lesions located intracapsularly. All the lesions were well-defined, nine of them were regular. The tumor sizes ranged from 15 to 80 mm with mean (43±19) cm. Intratumoral macroscopic fat, cystic degeneration and vessels were found in two lesions, two lesions and three lesions, respectively. Calcification or hemorrhage was not detected in any cases. On unenhanced CT, 70% cases were hyperattenuating. Eight cases were homogeneous or slightly heterogeneous. The mean attenuation of the tumor lesions on unenhanced CT was (48.60±5.50) HU, which was higher than that of normal renal parenchyma (39.70±6.67) HU (P<0.05), and similar to that of skeletal muscle (48.9±2.28) HU (P>0.05). After intravenous injection of contrast media, seven cases were categorized as the slightly heterogeneous or heterogeneous enhancement type. Four cases showed a weak enhancement whereas five cases were with a moderate enhancement. The gradual, prolonged and early washout enhancement patterns were observed in 40%, 40%, and 20% of the cases, respectively. Conclusion: The radiological appearance of mAML had a tendency to be hyperattenuating on unenhanced CT images without macroscopic fat; it could be homogeneous or slightly heterogeneous on unenhanced scans. After the injection of contrast agent, mAML tended to have a weak or moderate, lightly heterogeneous to heterogeneous enhancement, and it could demonstrate gradual and prolonged enhancement patterns.

Background:Complete colonoscopy is key to the diagnosis and treatment of colorectal disease,its role in reducing the morbidity and mortality of colorectal cancer is well known.Nonetheless,there are numerous factors,not just from the endoscopist's perspective but also from the patient's,that can potentially increase the difficulty of completing a colonoscopy.Aims:To identify patient-related factors that influenced the difficulty of a colonoscopy.Methods:Through two rounds of expert consultation,the factors that might affect the difficulty of colonoscopy were selected.A total of 1621 consecutive painless colonoscopies from Jan.2021 to Jan.2022 at the endoscopy center of The Affiliated Wuxi People's Hospital of Nanjing Medical University were evaluated in a retrospective manner.Factors including demographic data,cecal insertion time,adenoma detection rate and so on were recorded.These factors were analyzed to determine their association with difficulty by using Logistic regression model.Results:A total of 29 patient-related factors affecting the difficulty of colonoscopy were selected.Through retrospective analysis,the mean age of 1621 cases was(47.45±13.27)years,of which 45.8%were male and the mean body mass index was(23.32±3.11)kg/m2.Logistic regression analysis revealed that age≥60 years(OR=2.890,95%CI:1.957-4.269,P<0.001),female gender(OR=0.324,95%CI:0.217-0.484,P<0.001),history of gynecological surgery(OR=14.895,95%CI:9.741-22.776,P<0.001),constipation for 20-30 years(OR= 1.412,95%CI:0.925-2.156,P=0.010)were independent risk factors for difficult colonoscopy.Conclusions:This retrospective study identified several patient-related factors that influence the technical difficulty of colonoscopy.These findings had implications for practice and teaching of colonoscopy.

Objective To evaluate the effect of water exchange method versus conventional methods including air insufflation and carbon dioxide insufflation method for the quality of colonoscopy.Methods We searched related randomized controlled trials published up to October 2022 from PubMed,Web of Science,the Cochrane Library,SinoMed databases,CNKI,Wanfang data.Two reviewers independently searched the literatures based on standards to extract the data and evaluate the quality.Meta-analysis was conducted by RevMan 5.4.1.Results 23 studies involving 10654 patients were included.Although cecal intubation time was prolonged in water exchange(MD=1.81,95％CI:1.28～2.35,P=0.000),but water exchange had higher adenoma detection rate(ADR)(O(R)=1.40,95％CI:1.26～1.55,P=0.000),cecal intubation rate(O(R)=1.62,95％CI:1.24～2.10,P=0.000)and scores of bowel preparation quality(MD=0.61,95％CI:0.42～0.79,P=0.000)compared with conventional colonoscopy.In addition,WE had significantly lower pain sores(MD=-1.07,95％CI:-1.39～-0.76,P=0.000),number of abdominal compression(O(R)=0.42,95％CI:0.29～0.60,P=0.000)and number of position change(O(R)=0.59,95％CI:0.42～0.82,P=0.002)than conventional colonoscopy.Conclusion Although water exchange colonoscopy prolongs cecal intubation time,but it can significantly increase ADR,cecal intubation rate and scores of bowel preparation quality.Beyond that,water exchange reduces patient pain,the proportion of abdominal compression and position change.Water exchange is a better choice for high-quality colonoscopy.