Quality marker (Q-Marker) is an innovative concept and model for quality control of Traditional Chinese medicines (TCMs), which will navigate the new direction of quality development of TCMs. Yet, how to characterize the overall quality attributes of TCMs and their biological effects is still debating. In view of this key scientific issue, this paper proposes a research method based on mass spectrometry imaging (MSI) technology for the discovery and confirmation of TCMs Q-Marker. MSI is powerful in investigating the spatial distribution of molecules in a variety of samples, and visualizing the information obtained from MS. On this basis, combine with the five principles of TCMs Q-Marker validation, i.e., specificity, transmission and traceability, testability, prescription compatibility, and validity, were applied to confirm the finalized Q-Marker. It will lead the new direction of quality development of TCMs.

Purpose To investigate the difference of resting-state functional connectivity density(FCD)between chronic primary insomnia patients and healthy controls via resting state functional magnetic resonance imaging(rs-fMRI).Materials and Methods All rs-fMRI data of 35 patients with chronic primary insomnia from Xidian Group Hospital and Xi'an Encephalopathy Hospital of Traditional Chinese Medicine,and 35 healthy controls were prospectively collected from August 2020 to December 2021.The voxel-wise FCD approach was applied to explore the differences of whole-brain functional networks between chronic primary insomnia patients and healthy controls.The relationships between FCD value and Pittsburgh sleep quality index,self-rating scale of sleep,insomnia severity index,self-rating anxiety scale and self-rating depression scale in primary insomnia patients were investigated,respectively.Results Compared with healthy controls,the decreased FCD values were showed in the right insula,bilateral anterior cingulate gyrus,left orbitofrontal middle gyrus,left dorsolateral superior frontal gyrus,right medial superior frontal gyrus and bilateral thalamus(t<-5.271,Padjust<0.05),while the increased FCD values showed in the right superior temporal gyrus,bilateral middle temporal gyrus,bilateral precuneus and left posterior cingulate gyrus(t>4.379,Padjust<0.05)in the chronic primary insomnia patients group.The FCD values of bilateral thalamus(r=-0.620,P<0.001;r=-0.562,P<0.005)and right insula(r=-0.651,P<0.001)were negatively correlated with insomnia severity index in the chronic primary insomnia patients group,respectively.Conclusion The extensive functional connectivity abnormalities are observed in primary insomnia patients via FCD analysis.These findings explain the neural mechanisms of underlying emotional regulation and cognitive impairment in chronic insomnia from the perspective of functional integration and functional separation.

Objective:To investigate the effects of tuina, treadmill running or both on the expression of factors related to gastrocnemius muscle proteins after acute muscle injury and to explore the mechanisms involved.Methods:Thirty adult male Sprague-Dawley rats were randomly divided into a control group, a natural recovery group, a tuina group, a treadmill running group and a combined treatment group, each of 6. An impactor was used to induce an acute skeletal muscle injury in the right hind legs of all of the rats except those of the control group. One day after the successful modelling, the tuina, treadmill running and combined groups were given interventions as their name implied, 5 times a week for 3 weeks. The gait of rats in each group was analyzed and the number of times the rats fell into and striken by the electrical grid was counted. The injured muscles′ cross-sectional areas (CSAs) and the diameters of muscle fibers were observed using hematoxylin and eosin staining. The expression of mTOR, p-mTOR, p70S6K, p-p70S6K and smad2/3 protein were tested using western blotting. The relative expression of myostatin (MSTN) mRNA was measured using real-time quantitative polymerase chain reactions.Results:Compared with the natural recovery group, all the other groups fell into the electrical grid significantly less often. The average CSA and wet weight of the affected gastrocnemius had increased significantly in the tuina, treadmill running and combined treatment groups, with the average CSA increases in the treadmill running and combined treatment groups significantly greater compared with the tuina group. The average relative expression of mTOR, p-mTOR, p70S6K, and p-p70S6K in the other four groups increased significantly compared with the control group, while that of Smad2/3 and MSTN decreased significantly. Compared with the natural recovery group, the average increases in the other groups were significantly greater. Compared with the tuina group, the treadmill running and combined treatment groups showed significantly better improvements, on average.Conclusions:Tuina, treadmill running and their combination all can improve recovery from skeletal muscle trauma, at least in rats. However, treadmill running and combined treatment are more effect than tuina alone.

Objective:To analyze efficacy of comprehensive surgical treatment for Kasabach-Merritt phenomenon (KMP) .Methods:Clinical data were collected from 18 patients with KMP who underwent surgical treatment in Department of Hemangioma, Henan Provincial People′s Hospital from November 2017 to March 2019, and analyzed retrospectively. Preoperative treatment included preoperative use of glucocorticoids and immunoglobulins to increase platelet counts in patients. For patients irresponsive to glucocorticoids, a single large-dose of platelets was infused 12-24 hours before surgery. The platelet dose for infusion should be 0.3 and 0.2 therapeutic dose (TD) /kg respectively for patients with platelet counts lower than 30 × 10 9/L and those with platelet counts higher than 30 × 10 9/L, and the total infusion dose should be no more than 1 TD (containing about 2.5 × 10 11 platelets in 200-250 ml of infusion solution) . During the operation, tumor tissues were removed as much as possible; if there were difficulties in suturing in patients with large tumors, in situ autologous skin grafting would be performed; for children with potential postoperative functional dysfunction, a clinical consultation with rehabilitation specialists was given, and individualized functional exercises were prescribed to promote functional restoration. Results:Eighteen patients were enrolled, including 9 males and 9 females, with an average age of 73 days (range, 7-354 days) . Skin lesions were located on the extremities in 3 cases, on the trunk in 11, and on the head, face and neck in 4. Surgeries were successful in 17 patients, but 1 died. Among the 17 patients with successful operation, platelet counts and coagulation function returned to normal within 1 week after the surgery in 16, and did not returned to normal until after regular oral administration of sirolimus in 1. Favorable movement ability was maintained in all the children.Conclusion:Comprehensive surgical treatment shows rapid efficacy with less adverse reactions in the therapy of KMP.

Cardiac magnetic resonance (CMR) imaging provides accurate anatomic information and advanced soft contrast, making it the reference standard for assessing cardiac volumes and systolic function. In this review, we summarize the recent advances in CMR sequences. New technical development has widened the use of CMR imaging beyond the simple characterization of myocardial scars and assessment of contractility. These novel CMR sequences offer comprehensive assessments of coronary plaque characterization, myocardial fiber orientation, and even metabolic activity, and they can be readily applied in clinical settings. CMR imaging is able to provide new insights into understanding the pathophysiologic process of underlying cardiac disease, and it can help physicians choose the best treatment strategies. Although several limitations, including the high cost and time-consuming process, have limited the widespread clinical use of CMR imaging so far, recent advances in software and hardware technologies have made the future more promising.

Objective: To compare the curative effects between our self-designed flexible vertebroplasty device and the conventional straight bone cement injector in the treatment of osteoporotic thoracic compression fractures. Methods: A retrospective case-control study was conducted to analyze the clinical data of 140 patients with osteoporotic thoracic compression fracture who had been admitted to Department of Spine Surgery, Xi’an Honghui Hospital from June 2016 to January 2017. They were 61 males and 79 females, aged from 55 to 88 years (average, 70.3 years). Their fractured vertebrae distributed from T5 to T12. Our self-designed flexible vertebroplasty device was used in 67 of them (group A) while the conventional straight bone cement injector in the other 73 patients (group B). The 2 groups were compared in terms of operative time, amount of bone cement injected, distribution ratio of bone cement on the contralateral side, bone cement leakage, and visual analogue scale (VAS), anterior height ratio of the fractured vertebra and kyphosis cobb angle at 1 d, 1 and 2 years after operation. Results: The 2 groups were comparable due to their insignificant differences in preoperative general data (P>0.05). All the patients were followed up for more than 2 years, with an average of 26.7 months. There were no significant differences between the 2 groups in operation time (28.1±4.2 min versus 26.3±3.2 min) or in bone cement leakage [34.3%(23/67) versus 17.8%(13/73)] (P>0.05). However, group A was significantly higher than group B in amount of bone cement injection (5.6±1.2 mL versus 4.9±1.1 mL) and in distribution ratio of bone cement on the contralateral side (71.5%±11.3% versus 65.7%±12.9%), significantly lower than group B in VAS at 1 and 2 years after operation (2.8±0.7 and 3.0±0.9 versus 3.1±0.8 and 3.4±0.8) and in kyphosis cobb angle at 1 and 2 years after operation (25.2°±5.2° and 26.8°±5.5° versus 27.7°±4.9° and 29.1°±1.6°), and significantly higher than group B in anterior height ratio of the fractured vertebra at 1 and 2 years after operation (39.2%±8.1% and 37.1%±7.2% versus 35.4%±7.8% and 33.2%±8.4%) (all P< 0.05). There were no significant differences between the 2 groups in VAS, anterior height ratio of the fractured vertebra or kyphosis cobb angle at one day after operation (P>0.05). Conclusions Compared with the conventional straight bone cement injector, our self-designed flexible vertebroplasty device can lead to better contralateral distribution of bone cement, more effective maintenance of the height of injured vertebra, and better long-term analgesic effect in the treatment of osteoporotic thoracic compression fractures.

Cardiac magnetic resonance (CMR) imaging provides accurate anatomic information and advanced soft contrast, making it the reference standard for assessing cardiac volumes and systolic function. In this review, we summarize the recent advances in CMR sequences. New technical development has widened the use of CMR imaging beyond the simple characterization of myocardial scars and assessment of contractility. These novel CMR sequences offer comprehensive assessments of coronary plaque characterization, myocardial fiber orientation, and even metabolic activity, and they can be readily applied in clinical settings. CMR imaging is able to provide new insights into understanding the pathophysiologic process of underlying cardiac disease, and it can help physicians choose the best treatment strategies. Although several limitations, including the high cost and time-consuming process, have limited the widespread clinical use of CMR imaging so far, recent advances in software and hardware technologies have made the future more promising.
Cardiac Volume ; Cardiology ; Cicatrix ; Heart Diseases ; Magnetic Resonance Imaging

Objective To compare the prevalence of HIV/STD and related health care seeking behaviors among male STD clinic attendees between Xi'an and Xianyang cities.Methods During June and July 2016,206 male STD clinic attendees were studied in Xi'an city,with another 221 male STD clinic attendees in Xianyang city.Cross-sectional questionnaire survey was used to collect attendees' behavioral information.Blood samples were collected via HIV/HCV/Syphilis testing.Results The prevalence rate of HIV infection was 2.4％ (5/206) in Xi'an and 0.9％ (2/221) in Xianyang,with no statistical significant difference between the two cities.The prevalence rate of syphilis was 4.9％ (10/206) in Xi'an,which was significantly lower than 13.6％ (30/221) in Xianyang.The proportion of respondents,diagnosed with other sexually transmitted diseases,in Xi'an was higher than that of Xianyang.The proportions of commercial heterosexual sex and sex with temporary sexual partners in the past 3 months were 18.0％ (37/206) and 15.5％ (32/206) in Xi'an,lower than 46.6％ (103/221) and 15.8％ (35/221) in Xianyang (x2 =39.70,P ＜0.01;x2 =-0.01,P=0.93).The proportions of condom use with commercial sex workers or temporary sexual partners in the past 3 months among Xi'an were 37.8％ (14/37) and 6.3％ (2/32),lower than 93.1％ (95/102)and 57.1％ (20/35) in Xianyang (x2=49.06,P＜0.01;x2=19.63,P＜0.01).Conclusion Differences were noticed between Xi'an and Xianyang city in terms of STD and HIV prevalences,behaviors related to commercial sex and use of condoms among the male STD clinic attendees that calling for targeted actions in control of high risk behaviors in both HIV/AIDS and STDs transmission.

Objective To analyze the characteristics on demographical,spatial distribution and transmission mode of HIV infections among 50-year-old population.Methods Related information on demography,spatial distribution,high risk behavioral and history of HIV infections among 50-year-old population were collected and analyzed.Possible time of infection based on their first CD4 testing results right after the HIV diagnoses,was estimated.Results Since 2008,the number of new HIV/AIDS cases among the over-50-year-olds was reported increasing annually.The number of aged 50 and above in 2014 was 4.2 times than the number in 2008.50-year-old or older population were infected mainly through heterosexual behavior (88.0％).Among these cases,83.9％ self-reported as having histories on extramarital sex intercourse and the number was increasing yearly.Among male cases who admitted as having heterosexual experience,95.1％ of them reported as having histories of extramarital sex intercourse while 53.4％ of the female cases reported as having the same experiences.46.6％ of spouses of the females or with fixed partners were HIV positive.Through estimating the time of infection and the time interval between infection and diagnosis,we found that the proportion was 15.5％,from infection to diagnosis as 3 years among the 50 and older age groups,but the proportion of 8 years from infection to diagnosis was 43.6％.We estimated that 66.5％ of the new HIV cases who were at age 50 and over,were infected when they were at that age span.The average time from infection and being tested was (6.8 ± 2.7) years.Conclusion The increasing number of being diagnosed on HIV among the 50-year-olds population might be related to both high risk exposure and belated diagnoses among this population,calling for the necessity of deriving the sources of HIV infection and tailoring the HIV prevention strategies in this population.

Objective To characterize the migration patterns of men who have sex with men (MSM) living with HIV/AIDS in the period 2008-2015 and to characterize the determinants of their migration.Methods All identified HIV/AIDS cases transmitted through self-reported homosexual contact reported to the National Case Reporting System(CRS) by the end of December 31,2015 were included in this study.Data of basic demographic characteristics,household registration and address of the research objects were collected.Retrospective cohort study was used to analyze the migration characteristics of HIV/AIDS cases between 2008 and 2015.We used the x2 test to analyze their migration patterns and epidemiological characteristics,and multilevel logistic regression to investigate the determinants of migration.Results While mobile cases comprised 46.1％ of the sample (n=54 714),we detected a significant rising trend (x2=130.93,P＜0.001) as this proportion rose from 42.0％ (1 335/3 182) in 2008 to 47.9％ (15 623/32 610)in 2015.Of the 13 580 mobile cases with Hukou registration in Eastern China,89.8％ (12 201) migrated to other parts of Eastern China.Meanwhile,52.0％ of the 26 088 cases registered in Central China (n=13 570)and 30.5％ of the 14 106 registered in Western China (n=4 298) migrated to Eastern China.Furthermore,96.2％ of mobile cases (n=52 627) resided in the urban areas,of which 40.8％ (n=21 452) migrated from rural areas to urban areas and 58.4％ (n=30 722) migrated between urban areas.The annual proportion of cases who changed their address within 1 year of diagnosis ranged from 12.0％-18.5％.The results of the multilevel model showed that cases who were aged 25-49 years (OR=1.30,95％CI:1.26-1.34),single (OR=1.95,95％CI:1.87-2.02),and had a high school education or above (OR=1.68,95％CI:1.64-1.73)were more likely to migrate.AIDS (OR=0.71,95％CI:0.69-0.74),Hukou registration in an urban area (OR=0.63,95％CI:0.61-0.65),in Central China (OR=0.84,95％CI:0.73-0.97),Western China (OR=0.75,95％CI:0.64-0.87),and in regions with a high population density or above-average gross domestic product (GDP) per head (OR=0.77,95％ CI:0.69-0.87 and OR=0.70,95％ CI:0.62-0.79,respectively) were negatively associated with migration.Conclusion The number and proportion of mobile HIV cases showed a rising annual trend.Age,marital status,level of education and disease severity,in addition to the population density and level of economic development of cases' place of origin,were significant determinants of migration.