Background: The genus Atractylodes, native to East Asia, encompasses several species that serve as sources for the widely used traditional Chinese medicines Atractylodis Macrocephalae Rhizoma and Atractylodis Rhizoma. However, the international trade arouses concern regarding potential confusion and misidentification of Atractylodes species. Objective: A comprehensive understanding of the chemical diversity is crucial for ensuring the quality and exploring the potential variations in medicinal efficacy of Atractylodes. Methods: The GC-MS/MS-based metabolomics and multivariate statistical analysis identified 589 differentially accumulated metabolites across 5 Atractylodes species. Results: A total of 150 metabolites were predicted as potential chemical markers for species differentiation and quality assessment of Atractylodes. According to the metabolic profiles, the species of Atractylodes can be roughly classified into three categories: A. lancea and A. coreana with the volatile oil components being mainly atractylodin and β-eudesmol; A. macrocephala with the biomarker being atractylon; and A. japonica and A. carlinoides lying between the two categories above. Conclusions: Metabolomic results indicated that the metabolic profiles of A. carlinoides and A. macrocephala were similar and distinct from those of the other three species. Sesquiterpenoids were the main chemical components in the rhizome of A. carlinoides, which indicated the potential medicinal value of this plant.

Background: The genus Atractylodes, native to East Asia, encompasses several species that serve as sources for the widely used traditional Chinese medicines Atractylodis Macrocephalae Rhizoma and Atractylodis Rhizoma. However, the international trade arouses concern regarding potential confusion and misidentification of Atractylodes species. Objective: A comprehensive understanding of the chemical diversity is crucial for ensuring the quality and exploring the potential variations in medicinal efficacy of Atractylodes. Methods: The GC-MS/MS-based metabolomics and multivariate statistical analysis identified 589 differentially accumulated metabolites across 5 Atractylodes species. Results: A total of 150 metabolites were predicted as potential chemical markers for species differentiation and quality assessment of Atractylodes. According to the metabolic profiles, the species of Atractylodes can be roughly classified into three categories: A. lancea and A. coreana with the volatile oil components being mainly atractylodin and β-eudesmol; A. macrocephala with the biomarker being atractylon; and A. japonica and A. carlinoides lying between the two categories above. Conclusions: Metabolomic results indicated that the metabolic profiles of A. carlinoides and A. macrocephala were similar and distinct from those of the other three species. Sesquiterpenoids were the main chemical components in the rhizome of A. carlinoides, which indicated the potential medicinal value of this plant.

Background: The genus Atractylodes, native to East Asia, encompasses several species that serve as sources for the widely used traditional Chinese medicines Atractylodis Macrocephalae Rhizoma and Atractylodis Rhizoma. However, the international trade arouses concern regarding potential confusion and misidentification of Atractylodes species. Objective: A comprehensive understanding of the chemical diversity is crucial for ensuring the quality and exploring the potential variations in medicinal efficacy of Atractylodes. Methods: The GC-MS/MS-based metabolomics and multivariate statistical analysis identified 589 differentially accumulated metabolites across 5 Atractylodes species. Results: A total of 150 metabolites were predicted as potential chemical markers for species differentiation and quality assessment of Atractylodes. According to the metabolic profiles, the species of Atractylodes can be roughly classified into three categories: A. lancea and A. coreana with the volatile oil components being mainly atractylodin and β-eudesmol; A. macrocephala with the biomarker being atractylon; and A. japonica and A. carlinoides lying between the two categories above. Conclusions: Metabolomic results indicated that the metabolic profiles of A. carlinoides and A. macrocephala were similar and distinct from those of the other three species. Sesquiterpenoids were the main chemical components in the rhizome of A. carlinoides, which indicated the potential medicinal value of this plant.

Objective:To analyze the clinical characteristics and outcomes of non-aspergillus molds infection (NAMI) patients who underwent allogeneic stem cell transplantation.Methods:Total 24 patients diagnosed as proven or probable non-aspergillus molds infection after allo-HSCT at the Peking University Institute of Hematology from January 2010 to December 2016 were retrospectively reviewed.Results:Among the 24 non-aspergillus molds infection patients, 22 (91.6%) underwent haploidentical stem cell transplantation, while 1 (4.2%) underwent matched-sibling donor transplantation, and 1 (4.2%) underwent HLA-matched unrelated donor transplantation. Ten (41.7%) patients were diagnosed as proven NAMI, and 14 (58.3%) were probable NAMI. The median time to NAMI diagnosis was 188 (2-856) d after transplantation. Five (20.8%) patients had Mucorales infection, 14 (58.3%) Rhizopus infection, 3 (12.5%) had Absidia orchidis infection, and 2 (8.3%) had Scedosporium apiospermum infection. The response rate at was 38.9% (7/18) in 18 patients who adjusted antifungal therapy based on the etiology. After a median 229 (2-2280) days follow-up after diagnosis, the 2-year overall survival was (24.0±14.5) %.Conclusion:The major pathogen of NAMI after allo-HSCT was Rhizopus, and the mortality of NAMI after allo-HSCT was very high due to lack of early effective therapy.

We aimed to identify the effect of positive stool cultures (PSCs) on the clinical outcomes of patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT) (n = 332). PSCs were observed in 61 patients (PSC group, 18.4%). Enterobacteriaceae in stool specimens was associated with a higher risk of bloodstream infection, and Candida in stool specimens was related to a higher risk of platelet engraftment failure. The cumulative incidence of infection-related mortality 1 year after haplo-HSCT in the PSC group was higher than that of the patients who showed persistently negative stool cultures (NSC group; 19.2% vs. 8.9%, P = 0.017). The probabilities of overall survival (71.4% vs. 83.8%, P = 0.031) and disease-free survival (69.6% vs. 81.0%, P = 0.048) 1 year after haplo-HSCT for the PSC group were significantly lower than those for the NSC group, particularly for patients who had Candida in their stool specimens. In multivariate analysis, Candida in stool specimens significantly increased the risk of mortality and was associated with poorer survival. Our results showed that PSC influenced the clinical outcomes after haplo-HSCT, particularly those who had Candida in their stool specimens.

In order to study whether Paris forrestii could be developed as a substitute of Paridis Rhizome, chemical compositions of P. forrestii and P. polyphylla var. yunnanensis were investigated by UPLC-Q-TOF MS. In addition, the contents of eight primary steroidal saponins in 77 batches of P. forrestii samples from different habitats were simultaneously determined by HPLC-UV. The results showed that P. forrestii and P. polyphylla var. yunnanensis have similar chemical compositions, and all 22 major common peaks were identified as steroid derivatives. Meanwhile, there were some differences in the contents of saponins in P. forrestii samples from different habitats. The contents of 4 steroidal saponins in Chinese Pharmacopoeia ranged from 0.068% to 3.30%, and the highest content of the 8 kinds of steroidal saponins was 6.18%, while the lowest was just 0.71%. Moreover, 78% of P. forrestii samples were in conformity with the requirements of Chinese Pharmacopoeia, indicating that P. forrestii samples had relatively stable quality and could be further studied as a substitute for Paridis Rhizome.

The study was established an HPLC method for simultaneous determination of 8 steroidal saponins (polyphyllins Ⅶ, H, Ⅵ, Ⅱ, Ⅰ, and Ⅴ, dioscin, and gracillin) in Paridis Rhizoma, and made an evaluation by determining steroidal saponins in 15 kinds of genus Paris. The analysis was performed on a Waters Acquity H-ClassTM UPLC ultrafine liquid chromatography system coupled with a PDA detector. The chromatographic separation was achieved through a CAPCELL PAK ADME (4.6 mm× 250 mm, 5 μm) column and the optimal mobile phase consisted of acetonitrile and water. The column was maintained at 21 ℃, and the flow rate was 0.8 mL•min ⁻¹. The UV detection wavelength was 203 nm. The results showed that ① the detected components can be well separated and all with good correlation coefficients. The standard calibration curves were linearly good (R2>0.999 9). The linearity was obtained over 0.041 70-3.812 00 μg. The average recoveries ranged from 95.91% to 103.8%. ② there are significant differences in the content of steroidal saponins from different species. The steroidal saponins are low content or almost none in P. mairei, P. polyphylla var. stenophylla, and P. delavayi have low content or almost did not contain, so these species are not suitable for medicinal use. The contents of steroidal saponins in P. polyphylla var. chinensis are varied from different places. There were high content of steroidal saponins in P. polyphylla var. yunnanensis, P. forrestii, P. daliensis, and P. axialis, even up to 5.0%, which indicated that they had the potential pharmic value of development.

Objective To evaluate perioperative nutritional support for patients with acute abdomen in enhanced recovery after surgery (ERAS) programme.Methods A total of 490 patients with acute abdominal disease were collected,287 in ERAS group and 203 in conservative perioperative management (CPM) group.Biochemical and clinical markers of the 2 groups were compared.Results ERAS group had higher plasma albumin level,quicker bowel function recovery,lower postoperative complications,shorter hospital stay,and a lower WHO pain rating scale (all P ＜ 0.05).Conclusion With perioperative nutritional support,ERAS programme can accelerate recovery after emergency surgery,reduce the rate of overall complications,promote bowel function recovery,and decrease morbidity in the perioperative period for patients with acute abdominal disease.

Objective To discuss the effects of PBL teaching mode training on the core capability of new nurses .Methods Totally 27 nurses recuited from October 2014 to September 2015 in Xuhui District Central Hospital of Shanghai ,were selected as the observation group , while 26 nurses recuited from Semptember 2013 to August 2014 were selected as the control group .Nurses in the observation group received a 12-month PBL teaching mode training on the basis of traditional teaching method .While nurses in the control group received traditional teaching method .The core abiity and theoretical operation score of nurses in two groups were compared after training .Results Before the intervention , there is no significant difference in the score of items of nurses′core capability and the achievements of theoretical operation between two groups ( P>0.05) .After the intervention , each individual item score of nurses′core capability was as the following: assessment and intervention ( 3.20 ±1.11 ) , communication ( 4.25 ±1.25 ) , critical thinking ( 2.65 ±0.58 ) , interpersonal communication (4.85±1.89), comprehensive knowledge (3.58±1.02), management (2.10±1.29), leadership (2.10±1.29) and teaching (3.08±1.12); while the scores of those items in the control group were (2.21± 0.36), (3.68±1.31), (2.10±0.65), (4.21±1.02), (2.85±0.62), (1.65±0.35), (1.65±0.35) and (2.51± 0.39) (t=6.230,9.187,5.102,2.587,10.526,2.580,2.580,3.815;P<0.05).After the training, the score of theoretical operation in the observation group was (87.74±2.21), while the score in the control group was (75.15±1.59) ( t=7.023,P<0.05).Conclusions PBL teaching mode training can effectively improve the core ability and theoretical operation of new nurses .

Through the combination of science and technology and humanities :thinking on independent set of general education in medical colleges , pointed out that:set the idea of medical humanismmedical education;general medicine education content and method should have compatible science and technology and humanities ;general education should re-turn to traditional Chinese medicine and also to the world;experience both at home and abroad for reference to build the medicine and the humanities general education courses to strengthen comprehensive combination of science and technology and humanities , to further promote the improvement of the medical college general education .