Fenugreek is a kind of Chinese herbal medicine with great development prospects.At present,there are many modern reports on its components extraction,quality standards,processing technology and pharmacological effects.However,there is still a lack of research on sorting out and analyzing the relevant ancient records,and people's herbological cognition of fenugreek is still controversial and incomplete.In this study,through systematic review and analysis of ancient records,the names,original plant,processing methods and properties(including nature,flavor,meridian tropism,action,application,toxicity and contraindication)of fenugreek were comprehensively verified for the first time,which provided a herbological reference for further development,utilization and in-depth study of Fenugreek.It is found that fenugreek has several names such as Kudou,Luba,Huba and Jidou.Based on analyzing the descriptions and pictures of fenugreek original plant in ancient records,there is a strong likelihood that the ancient and modern medicinal fenugreek belong to the same species.In addition to the current common method of stir-frying with salt solution,the ancient books also recorded eight processing methods of fenugreek,such as stir-frying,steaming,baking,and calcining.According to the research of properties,it is found that fenugreek is warm-hot in nature,bitter,sweet,and pungent in flavor,and attributive to the kidney,stomach,liver and bladder meridians.In addition to the efficacy recorded in pharmacopoeia,this study also complemented fenugreek's actions of"improving hearing and eyesight,guiding fire to origin"and application of"fullness and discomfort in abdomen and hypochondrium".According to the textual research of toxicity and contraindication,fenugreek has been recorded as non-toxic in the past dynasties,but it should be used cautiously in the excess-heat syndrome,Yin deficiency syndrome,and pregnant women.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.