ObjectiveTo explore the quantity-quality transfer process of medicinal materials， decoction pieces and standard decoction of Haliotidis Concha（Haliotis discus hannai） by analyzing the physical phase and compositional changes， so as to provide references for the effective control of its quality. MethodsA total of 20 batches of Haliotidis Concha（H. discus hannai） from different habitats were collected and prepared into corresponding calcined products and standard decoction， and the content of CaCO₃ of the three samples were determined and the extract yield and transfer rate of CaCO₃ were calculated. The changes in elemental composition and their relative contents were investigated by X-ray fluorescence spectrometry（XRF）， X-ray diffraction（XRD） was used to study the changes in the phase compositions of the three samples and to establish their respective XRD specific chromatogram. Fourier transform infrared spectrometry（FTIR） was used to study the changes in the chemical composition and content changes of the three samples and to establish their respective FTIR specific chromatogram， while combining hierarchical cluster analysis（HCA）， principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） to find the common and differential characteristics， in order to explore the quantity-quality transfer relationship in the preparation process of standard decoction of Haliotidis Concha（H. discus hannai）. ResultsThe CaCO₃ contents of the 20 batches of medicinal materials， decoction pieces and standard decoction of Haliotidis Concha（H. discus hannai） were 93.87%-98.95%， 96.02%-99.97% and 38.29%-51.96%， respectively， and the extract yield of standard decoction was 1.71%-2.37%， and the CaCO₃ transfer rate of decoction pieces-standard decoction was 0.68%-1.27%. XRF results showed that the elemental species and their relative contents contained in Haliotidis Concha and its calcined products had a high degree of similarity， and although there was no obvious difference in the elemental species contained in decoction pieces and standard decoction， the difference in the relative contents was obvious， which was mainly reflected in the decrease of the relative content of element Ca and the increase of the relative content of element Na. XRD results showed that Haliotidis Concha mainly contained CaCO₃ of aragonite and calcite， while calcined Haliotidis Concha only contained CaCO₃ of calcite， and standard decoction mainly contained CaCO₃ of calcite and Na₂CO₃ of natrite. FTIR results showed that there were internal vibrations of O-H， C-H， C=O， HCO₃^- and CO₃^2- groups in Haliotidis Concha， while O-H， HCO₃^- and CO₃^2- groups existed in the calcined products and standard decoction. ConclusionThe changes of Haliotidis Concha and calcined Haliotidis Concha are mainly the increase of CaCO₃ content， the transformation of CaCO₃ aragonite crystal form to calcite crystal form and the absence of organic components after calcination， and the changes of calcined products and standard decoction are mainly the decrease of CaCO₃ content and the increase of Na₂CO₃ relative content. The method established in the study is applicable to the quality control of the shellfish medicines-decoction pieces- standard decoction， which provides a new idea for the study of quality control of dispensing granules of shellfish medicines.

ObjectiveTo explore the quantity-quality transfer process of medicinal materials， decoction pieces and standard decoction of Haliotidis Concha（Haliotis discus hannai） by analyzing the physical phase and compositional changes， so as to provide references for the effective control of its quality. MethodsA total of 20 batches of Haliotidis Concha（H. discus hannai） from different habitats were collected and prepared into corresponding calcined products and standard decoction， and the content of CaCO₃ of the three samples were determined and the extract yield and transfer rate of CaCO₃ were calculated. The changes in elemental composition and their relative contents were investigated by X-ray fluorescence spectrometry（XRF）， X-ray diffraction（XRD） was used to study the changes in the phase compositions of the three samples and to establish their respective XRD specific chromatogram. Fourier transform infrared spectrometry（FTIR） was used to study the changes in the chemical composition and content changes of the three samples and to establish their respective FTIR specific chromatogram， while combining hierarchical cluster analysis（HCA）， principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） to find the common and differential characteristics， in order to explore the quantity-quality transfer relationship in the preparation process of standard decoction of Haliotidis Concha（H. discus hannai）. ResultsThe CaCO₃ contents of the 20 batches of medicinal materials， decoction pieces and standard decoction of Haliotidis Concha（H. discus hannai） were 93.87%-98.95%， 96.02%-99.97% and 38.29%-51.96%， respectively， and the extract yield of standard decoction was 1.71%-2.37%， and the CaCO₃ transfer rate of decoction pieces-standard decoction was 0.68%-1.27%. XRF results showed that the elemental species and their relative contents contained in Haliotidis Concha and its calcined products had a high degree of similarity， and although there was no obvious difference in the elemental species contained in decoction pieces and standard decoction， the difference in the relative contents was obvious， which was mainly reflected in the decrease of the relative content of element Ca and the increase of the relative content of element Na. XRD results showed that Haliotidis Concha mainly contained CaCO₃ of aragonite and calcite， while calcined Haliotidis Concha only contained CaCO₃ of calcite， and standard decoction mainly contained CaCO₃ of calcite and Na₂CO₃ of natrite. FTIR results showed that there were internal vibrations of O-H， C-H， C=O， HCO₃^- and CO₃^2- groups in Haliotidis Concha， while O-H， HCO₃^- and CO₃^2- groups existed in the calcined products and standard decoction. ConclusionThe changes of Haliotidis Concha and calcined Haliotidis Concha are mainly the increase of CaCO₃ content， the transformation of CaCO₃ aragonite crystal form to calcite crystal form and the absence of organic components after calcination， and the changes of calcined products and standard decoction are mainly the decrease of CaCO₃ content and the increase of Na₂CO₃ relative content. The method established in the study is applicable to the quality control of the shellfish medicines-decoction pieces- standard decoction， which provides a new idea for the study of quality control of dispensing granules of shellfish medicines.

AIM: To quantify early changes of macular capillary parameters in type 2 diabetic patients using optical coherence tomography angiography(OCTA).METHODS: Retrospective case study. A total of 49 healthy subjects, 52 diabetic patients without retinopathy(noDR)patients, and 43 mild nonproliferative diabetic retinopathy(mNPDR)patients were recruited. Capillary perfusion density, vessel length density(VLD), and average vessel diameter(AVD)were calculated from macular OCTA images(3 mm×3 mm)of the superficial capillary plexus after segmenting large vessels and the deep capillary plexus. Parameters were compared among control subjects, noDR, and mNPDR patients. The area under the receiver operating characteristic curve estimated the abilities of these parameters to detect early changes of retinal microvascular networks.RESULTS: Significant differences were found in the VLD and AVD among the three groups(P<0.001). Compared with the control group, the noDR group had significantly higher AVD(P<0.05). VLD of both layers in patients of mNPDR group was significant decreased compared with that of noDR group(all P<0.01). Deep AVD had a higher area under the curve(AUC)of 0.796 than other parameters to discriminate the noDR group from the healthy group. Deep AVD had the highest AUC of 0.920, followed by that of the deep VLD(AUC=0.899)to discriminate the mNPDR group from the healthy group.CONCLUSIONS: NoDR patients had wider AVD than healthy individuals and longer VLD than mNPDR patients in both layers. When compared with healthy individuals, deep AVD had a stronger ability than other parameters to detect early retinal capillary impairments in noDR patients.

Medicinal plants are a valuable source of essential medicines and herbal products for healthcare and disease therapy. Compared with chemical synthesis and extraction, the biosynthesis of natural products is a very promising alternative for the successful conservation of medicinal plants, and its rapid development will greatly facilitate the conservation and sustainable utilization of medicinal plants. Here, we summarize the advances in strategies and methods concerning the biosynthesis and production of natural products of medicinal plants. The strategies and methods mainly include genetic engineering, plant cell culture engineering, metabolic engineering, and synthetic biology based on multiple "OMICS" technologies, with paradigms for the biosynthesis of terpenoids and alkaloids. We also highlight the biosynthetic approaches and discuss progress in the production of some valuable natural products, exemplifying compounds such as vindoline (alkaloid), artemisinin and paclitaxel (terpenoids), to illustrate the power of biotechnology in medicinal plants.

Objective To investigate the predictive value of heart rate(HR),C-reactive protein(CRP),amino-probrain natriuretic hormone(NT-proBNP),myoglobin(MYO)and other clinical indicators for left ventricular systolic dysfunction(LVSD)in the patients with acute myocardial infarction(AMI)after percuta-neous coronary intervention(PCI)under different body mass index(BMI)stratification.Methods A total of 353 patients with AMI admitted and treated in the First Hospital of Lanzhou University from January 2020 to December 2020 were selected as the study subjects.The Simpson method was adopted to detect the left ven-tricular ejection fraction(LVEF).The study subjects with LVEF＜0.05 were included in the LVSD group,while those with LVEF ≥0.5 were included in the control group.The AMI patients were divided into the lean/normal type(BMI＜24 kg/m2)and overweight/obese type(BMI≥24 kg/m2)according to BMI.The general data of the patients,laboratory indexes and myocardial enzyme indicators were collected.The different groups with different BMI stratifications conducted the comparison.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were adopted to analyze the predictive efficiency of differ-ent indicators.Results There were 153 cases of lean/normal type AMI,in which there were 54 cases in the LVSD group and 99 cases in the control group.Among 200 cases of overweight/obese type AMI,60 cases were in the LVSD group and 140 cases were in the control group.In the patients with lean/normal AMI,HR,CRP,NT-proBNP,MYO and cTnl levels in the LVSD group were higher than those in the control group,and the differences were statistically significant(P＜0.05).In the patients with overweight/obese type AMI,HR,CRP,NEUT,PLT and NT-proBNP levels in the LVSD group were higher than those in the control group,the age was lower than that in the control group,and the differences were statistically significant(P＜0.05).In the patients with the lean/normal type AMI,HR was the best factor for single index prediction effect,AUC was 0.701(95％CI:0.612-0.790).HR+MYO+CRP was the best factors combination of com-bination prediction for LVSD in the patients with lean/normal type AMI.AUC was 0.769(95％CI:0.690-0.849).In the patients with overweight/obese AMI,NT-proBNP was the best factor for the best effect of sin-gle indicator prediction,AUC was 0.706(95％CI:0.613-0.786);NT-proBNP+CRP was the best factor combination in the combination for predicting LVSD in the patients with overweight/obese type AMI,AUC was 0.761(95％CI:0.687-0.833).Conclusion In the patients with different BMI stratifications of AMI,the combination prediction has a better predictive effect than the single indicator.HR+MYO+CRP has the better pre-dictive effect for LVSD in the patients with lean/normal type AMI,while NT-proBNP-+CRP has better predictive effect for LVSD in the patients with overweight/obese type AMI.

Coronary heart disease （CHD） with atherosclerosis is a common chronic disease worldwide， and anxiety and depression are potential and crucial risk factors for adverse prognosis in CHD. Chaihu Longgu Mulitang （CLMT）， first mentioned in the Shang Han Lun （《伤寒论》）， is a classic prescription for treating Shaoyang diseases combined with disturbance of the mind and spirit， with the effects of harmonizing Shaoyang and calming the mind. Current research on mechanisms has shown that CLMT can play a role in CHD complicated with anxiety and depression through multiple pathways， including regulating related signaling pathways， inhibiting the expression of inflammatory factors， improving oxidative stress damage， modulating neurotransmitter levels， suppressing the hypothalamic-pituitary-adrenal axis， promoting mobilization of mesenchymal stem cells from the bone marrow， and inhibiting platelet activation. Clinical studies have demonstrated that CLMT significantly improves symptoms such as angina and insomnia caused by CHD complicated with anxiety and depression， effectively reduces negative emotions， improves traditional Chinese medicine （TCM） syndrome scores， and decreases levels of inflammatory factors. Furthermore， it has fewer adverse reactions and higher safety than conventional western medicine treatments. This article provides a review of the mechanisms and clinical studies of CLMT in the treatment of CHD complicated with anxiety and depression based on a comprehensive analysis of literature from the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， PubMed， and other databases in the past 15 years， in order to provide references for further research on the use of CLMT in the management of CHD complicated with anxiety and depression.

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Objective To explore the operation procudure and notice of establishing a rat model of abdominal heterotopic heart transplantation by single operator,and summarize the detailed skill and experience for beginners.Methods 68 pairs male SD(recipients)/Wistar(donors) rats,preoperative anesthesia for recipients and donors at the same time,8/0 line was preparing for blocking recipients vena cava and abdominal aortic,blocking the branch vessel.Left and right superior vena ligature respectively with hilar,cutting the ascending aorta,perfusion cardioplegia,free pulmonary artery,across transverse sinus of pericardium for pulmonary artery cutting,atrial wash,free donor heart.Choosed appropriate incision of receptor abdominal blood vessels,mattress suture at 6 and 12 points,a single suture for vent gases,continuous suture in artery,single needle in vein,reperfusion after exhaust gas.Recording operation time,HE staining,IL-1β/CD3 immunohistochemistry slice,flow cytometry analysis of CD4+T/CD8+T lymphocytes subsets in the peripheral blood.Results Sixty-eight cases were treated by single operater,the operation time was(58.8±4.5)minutes,artery suture time was(7.6±2.2)minutes,vein suture time was(13.5±4.2)minutes,the total donor heart ischemic time was(31.8±4.5)minutes,the success rate was 88.2％.The rejection reaction was stronger on the third and fifth day after surgery,with high expression of IL-1β/CD3 in cardiac allografts.The CD4+T/CD8+T lymphocytes subsets increased in the peripheral blood at first day after heart transplantation.Conclusion By fully preparation and skillfully operation,establishing a rat model of abdominal heterotopic heart transplantation by single operator has a stable success rate.

Research teams work together to solve the technical bottleneck in the Panax notoginseng industry.These research directions mainly focus on breeding of new variety,alleviating the continuous cropping obstacles,building standard system and so on.We used methods such as biotechnology,information technology and so on,to realize digitization,network and intellectualization in the process of selection of producing areas,field management,harvest storage,solved key issues of the precise selection of producing areas,variety breeding,soil improvement,fertilization management,and realized the precision and optimization of ginseng cultivation.We built the composite technology system of pollution-free notoginseng.This technology system mainly contained the breeding of new cultivar,the composite technology of soil improvement,the cultivation system of pollution-free notoginseng and quality traceability system.A new disease-resistant cultivar of notoginseng was bred,which offered feasibility for the notoginseng continuous cropping.We first presented composite improvement technology of notoginseng continuous cropping soil.This improvement technology has been used in the field.This technology system of soil restoration and improvement guaranteed notoginseng continuous cropping.A first standard system of pollution-free notoginseng was issued.It established standard of high-quality notoginseng materials.Finally,quality traceability system of notoginseng was finished,which safeguarded the controllable quality.This composite technology system offers references for the cultivation of other Chinese herbal medicines.

Panax notoginseng (BurK.) F.H.Chen is a traditional Chinese medicinal material with a time-honored history of cultivation.There are a series of problems,such as high pesticide residues,serious disease and pest,and continuous cropping obstacles in the process of the cultivation of notoginseng.Pollution-free cultivation is an effective strategy for the sustainable development of notoginseng industry.We herein summarized three points of the pollution-free cultivation of notoginseng in this review.The standard of lands suitable for the cultivation of notoginseng was established on the basis of the analysis of medicinal plants around global producing areas.The integrated measures of soil improvement were put forward by cfficient rotation and soil disinfection with new varieties breeding combined with the management of water,light and fertilization,and the safe and low-toxic methods of disease and pest control.Additionally,the mode of wild tending should be carried out when the marker-assisted breeding of new varieties was developed,and the platform of comprehensive disease and pest control was founded.Above-mentioned points can effectively perfect and optimize the pollution-free cultivation of notoginseng and promote sustainable development of notoginseng industry.