Acute respiratory distress syndrome （ARDS） is believed to primarily result from a disorder of the qi movement， with qi dysfunction occurring first， followed by changes in fluids and blood. The disease is located in the lungs， with its root in qi and pathological changes in fluids and blood， aligning with the theory of "qi loses its regulatory function， fluids and blood follow the same path". Accordingly， ARDS is divided into three stages， the early stage with qi congestion， counterflow， fluids and blood obstruction， severe stage with qi collapse， yang depletion， fluids and blood out of control）， and recovery stage with qi consumption and fluids damage， residual pathogen retention. For the corresponding treatments， in the early stage， the focus is on diffusing the lung qi， opening the block， dissol-ving phlegm， and eliminating fluid retention， using Tingli Dazao Xiefei Decoction （葶苈大枣泻肺汤） and Xuanbai Chengqi Decoction （宣白承气汤） / Shegan Mahuang Decoction （射干麻黄汤） with modifications. In the severe stage， the priority is to reinforce qi， stabilize collapse， and promote diuresis and blood circulation， with modified Zhenwu Decoction （真武汤） and Shenge Powder （参蛤散）. During recovery stage， the emphasis shifts to replenishing qi and body fluids while clearing residual pathogens， with Shashen Maidong Decoction （沙参麦冬汤） and Bufei Decoction （补肺汤）. At the same time， from the perspective of "qi loses its regulatory function， fluids and blood follow the same path"， the mechanism of prone position ventilation （PPV） is explored. It is believed that the effect of "qi reaching the blood" via PPV by restoring the qi movement and unblocking qi， blood and water retention， which offers insights for the diagnosis and treatment of ARDS with integrated traditional Chinese and western medicine.

Objective:To compare the application effects of electric impedance tomography (EIT)-guided positive end-expiratory pressure conventional PEEP and PEEP-fraction of inspired oxygen (FiO 2) table-guided PEEP in the mechanical ventilation of patients with traumatic brain injury (TBI) complicated with acute respiratory distress syndrome (ARDS). Methods:A retrospective cohort study was conducted on the clinical data of 80 TBI patients complicated with ARDS admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from July 2020 to December 2022, including 42 males and 38 females, aged 29-59 years [(42.4±7.8)years]. The Glasgow coma scale (GCS) scores were 3-12 points [(7.7±2.2)points]. According to ARDS classification, 33 were mild, 26 moderate and 21 severe. All the patients were treated with mechanical ventilation according to lung protective ventilation strategy, including 42 patients treated with EIT-guided PEEP (EIT group) and 38 treated with conventional PEEP-FiO 2 table-guided PEEP (conventional group). At 12 hours, 1, 3 and 5 days after ventilation, the optimal PEEP, respiratory mechanics [driving pressure (ΔP), static compliance (C St), mechanical power (MP)], pulmonary gas exchange [arterial blood pH value, arterial partial pressure of carbon dioxide (PaCO 2), oxygenation index (P/F)], ventilation distribution [heterogeneity index (GI), regions of interest (ROI)1-4], hemodynamics [heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP)], cerebral perfusion status [intracranial pressure (ICP), regional cerebral oxygen saturation (rScO 2) grading], and treatment outcomes (mechanical ventilation duration, incidence of ventilator-induced lung injury (VILI), length of ICU stay, 6-month survival rate) separately at their optimal PEEP were compared between the two groups. Results:All the patients were followed up for 6 months. The optimal PEEP of the EIT group was (7.4±1.0)cm, (8.2±1.2)cm, (9.8±0.8)cm and (8.4±0.7)cm respectively at 12 hours, 1, 3 and 5 days after mechanical ventilation, which were higher than (7.0±1.0)cm, (7.6±1.0)cm, (9.0±0.6)cm and (7.2±0.5)cm of the conventional group ( P<0.05 or 0.01). At their optimal PEEP separately, at 12 hours, 1, 3 and 5 days after treatment, the ΔP of the EIT group was (7.1±1.3)cmH 2O, (7.7±1.3)cmH 2O, (9.5±1.1)cmH 2O and (6.1±1.3)cmH 2O respectively, which were all lower than (8.9±1.3)cmH 2O, (10.5±1.3)cmH 2O, (11.2±1.2)cmH 2O and (8.7±1.2)cmH 2O of the conventional group respectively ( P<0.05 or 0.01); the C St of the EIT group was (51.5±4.2)ml/cmH 2O, (52.9±4.6)ml/cmH 2O, (55.1±4.3)ml/cmH 2O and (57.5±3.6)ml/cmH 2O, which were all higher than (46.8±3.9)ml/cmH 2O, (47.6±4.4)ml/cmH 2O, (49.9±4.3)ml/cmH 2O and (53.3±3.6)ml/cmH 2O of the conventional group respectively ( P<0.05); the MP of the EIT group was (7.9±1.8)J/min, (8.8±1.3)J/min, (10.6±1.3)J/min and (7.8±0.9)J/min, which were lower than (8.6±1.5)J/min, (9.5±1.0)J/min, (12.2±1.8)J/min and (8.6±0.9)J/min of the conventional group respectively ( P<0.05 or 0.01); the P/F of the EIT group was (207.1±7.1)mmHg, (213.1±6.9)mmHg, (239.3±13.1)mmHg and (255.5±11.8)mmHg, which were all higher than (179.6±7.2)mmHg, (187.8±9.6)mmHg, (212.8±9.6)mmHg and (228.1±12.3)mmHg of the conventional group respectively ( P<0.05 or 0.01); the GI of the EIT group were 0.381±0.013, 0.387±0.012, 0.392±0.010 and 0.395±0.010, lower than 0.403±0.005, 0.406±0.005, 0.409±0.005 and 0.411±0.004 of traditional group respectively ( P<0.01); there were no significant differences in the arterial blood pH value, PaCO 2, ROI1-4, HR, CVP, MAP, ICP, or rScO 2 grading between the two groups (P>0.05). The ventilation duration of the EIT group was (78.5±9.0)hours, which was shorter than (83.1±7.4)hours of the conventional group ( P<0.05). The incidence of VILI was 0.0% (0/42) in the EIT group, which was lower than 7.8% (3/38) in the conventional group ( P<0.05). There were no significant differences in the ICU stay or 6-month survival rate between the two groups ( P>0.05). Conclusions:In mechanical ventilation treatment of TBI complicated with ARDS, the optimal PEEP guided by EIT was higher than that guided by PEEP-FiO 2 table. At this optimal PEEP, the respiratory mechanics and oxygen supply of the patients can be improved more effectively, making regional lung ventilation more uniform, reducing the mechanical ventilation time and decreasing the incidence of VILI without affecting their hemodynamics and brain perfusion.

Objective To perform the pharmacognostic identification of Anoectochilus lylei and establish the foundation for its accurate identification and further development. Methods The macroscopic identification and microscopic identification methods were used to identify A. lylei. Results A. lylei has ovate leaf shape, possessing red reticulated veins. Inverted flowers have Y-shaped and white lip. The anterior part of lip is two-lobed, and the lobes are linear-oblong. There are 1 to 3 shorts serrations on each side of the middle part of lip. Microscopic characteristics mainly show as follows: the cortex is broad in the transverse section of roots and stems; 1-5 and 1-7 vascular bundles in the xylem of transverse section of roots and stem, respectively. Collateral vascular bundle in the main veins of transverse section of leaves. There are multitudinous types of stomas in the leaf abaxial epidermis, most of which are anomocytic. Conclusion These characteristics could provide reference for the correct identification of A. lylei.

Objective To isolate the secondary metabolites of endophytic fungus Aspergillus sp. J218 from Anectochilus roxburhii. Methods Different chromatographic methods, including Sephadex LH-20 and silica gel chromatography as well as HPLC, were used to isolate compounds from the EtOAc fraction of the solid fermentation of J218, and their structures were identified by spectral methods. Results Ten compounds were isolated from the fermentation of J218 and their structures were individually identified as kotanin（1）, flavasperone（2）, aurasperone B（3）, fonsecinone B（4）, fonsecinone D（5）, ensidol A（6）, fonsecinone A（7）, fonsecinone C（8）, aurasperone A（9）, and fonsecinone F（10）. Conclusion Most compounds isolated from endophytic fungus Aspergillus sp. J218 in Anectochilus roxburhii were identified as dimeric naphthopyrones. These results suggest that this strain contains rich dimerization synthase, which could provide clues for the further exploration of the rational biosynthesis pathway of dimeric naphthopyrones in this strain.

Objective To study the effects of endophytic fungus Epichloë bromicola SH09 on the plant growth and accumulation of active components in Salvia miltiorrhiza, and improve the quality of medicinal plant S. miltiorrhiza. Methods E. bromicola SH09 solid bacterial fertilizer was prepared and co-cultured with S. miltiorrhiza for 60 d and 120 d. Four morphological indexes, fresh weight of roots, dry weight of roots, and the contents of four tanshinones and two phenolic acids in the roots of S. miltiorrhiza from treated group and control group were assayed, respectively. Results After 60 d and 120 d co-culture, E. Bromicola SH09 significantly increased the tiller number, plant height, leaf number, leaf area, fresh weight of roots, dry weight of roots, and the content of tanshinones and phenolic acids in S. miltiorrhiz. Conclusion The endophytic fungus E. bromicola SH09 can effectively promote the plant growth and improve the accumulation of active components in S. miltiorrhiza, which not only broadens the new ecological functions of endophytic fungi, but also improves the quality of medicinal plant S. miltiorrhiza.

Objective To establish the quality standards of Hirtula Roses for the quality control of production, supervision, circulation and application. Methods The moisture content, total ash, ethanol extract content and characteristic chromatogram of Rosa roxburghii Tratt. were determined according to the related determination method in Ⅳ-Part of Chinese Pharmacopeia 2020. Results There should be 6 characteristic peaks in the characteristic chromatogram of Rosa roxburghii Tratt., which should correspond to the retention time of 5 characteristic peaks in the reference chromatogram of the standard herbs, and another peak should correspond to the retention time of the reference chromatogram of isoquercitrin. The moisture content of Rosa roxburghii Tratt. should be less than 14.0%; the total ash content should be less than 5.0%; the ethanol extract content should be more than 20.0%. Conclusion According to the experimental results, the quality standard of Rosa roxburghii Tratt. is conformed to the national requirements of quality standards for traditional Chinese medicine, which could provide a reference for the quality control of Hirtula Roses.

Objective To identify the crude drugs of Anoectochilus burmannicus, and clarify its original plant pharmacognostical and microscopic characteristics. Methods The pharmacognostical identification method was used to observe the original plant, tissue structure and microscopic characteristics of A. burmannicus. Results Leaves were ovate or ovate elliptic with golden-red veins. Non-inverted yellow flowers had Y-shaped and yellow labellum, which were anteriorly enlarged and 2-lobed. The lobes were narrowly oblong or narrowly oblanceolate. The middle part of labellum was narrow to form a 10 mm long structure with margin narrowly winged. In the microscopic structure, the cortex is obvious in the cross sections of root and stem, together with needle crystals of calcium oxalate and mucous cells. The upper epidermal cells on the cross section of the leaves were papilloid in shape, whereas diverse stomas existed among the lower epidermal cells, with anomocytic stomas as the major type. Needle crystals of calcium oxalate and conduits can be found in the powder. Conclusion These data provide a reference for the identification and resource development and utilization of A. burmannicus.

Objective To investigate the change of biological characteristics after stable knockdown of the coding gene of 3-methylcrotonyl-coenzyme A carboxylase β subunit (MCCC2) expression in DU145 by lentivirus shRNA. Methods Three groups were included in this study. shNC was the control group in which MCCC2 was negatively knocked down in DU145. shMCCC2 was the experimental group in which MCCC2 was knocked down. DU145 was the blank group without any treatment. The expression of MCCC2 was assessed by Western blot and qPCR. The proliferation of DU145 cells was detected by CCK8 assay. The migration ability of DU145 was detected by transwell. The apoptosis of DU145 cells was detected by flow cytometry. Results The expression level of MCCC2 in shMCCC2 group was significantly lower than that in shNC group (0.22 ± 0.02 vs 0.61 ± 0.06, P < 0.001). The proliferation (2.24 ± 0.04 vs 3.13 ± 0.15) and migration (23.96 ± 1.85 vs 49.73 ± 0.63) of DU145 cells in shMCCC2 group was significantly lower than that in shNC group, whereas the apoptosis (12.64 ± 0.30 vs 3.68 ± 0.02) of DU145 cells in shMCCC2 was significantly higher than that in shNC group. Conclusion MCCC2 knockdown significantly inhibited the proliferation and migration, and induced apoptosis of DU145 cells, which indicated that the down-regulation of MCCC2 is correlated with the change of tumor biological characteristics of DU145 cell line and can be a potential target for the treatment of prostate cancer.

OBJECTIVE:To systematically review the efficacy and safety of reinforcing kidney and invigorating spleen princi-ple in the treatment of primary osteoporosis (POP) in middle and elderly aged patients,and provide evidence-based reference for clinic. METHODS:Retrieved from VIP,Wanfang Database,CJFD,Medline,PubMed,Elsevier,Springer,Web of Science and Ovid,randomized control trials (RCT) about reinforcing kidney and invigorating spleen principle (test group) versus other meth-ods(no reinforcing kidney and invigorating spleen principle,control group)in the treatment of POP were collected. Meta-analysis was performed by using Rev Man 5.3 software provided by Cochrane after data extraction and quality evaluation modified by Jadad scale. RESULTS:Totally 28 RCTs were enrolled,involving 2849 patients. Results of Meta-analysis showed,the total effective rate [OR=3.80,95%CI(2.76,5.23),P<0.001],BGP level [MD=2.23,95%CI(1.80,2.66),P<0.001],BMD level of femoral neck [MD=0.04,95%CI(0.00,0.08),P=0.05] and BMD level of lumbar spine [MD=0.07,95%CI(0.03,0.11),P=0.001] in test group were significantly higher than control group,ALP level [MD=-5.59,95%CI(-10.51,-0.66),P=0.03] and VAS score [MD=-1.38,95%CI(-1.87,-0.89),P<0.001] were significantly lower than control group,with statistical significance. There were no significant differences in U-Ca/Cr [MD=-0.07,95%CI(-0.17,0.02),P=0.12] and serum Ca2+ level [MD=0.16,95%CI (-0.07,0.39),P=0.17] in 2 groups. CONCLUSIONS:Reinforcing kidney and invigorating spleen principle can improve patients' osteogenesis during bone metabolism,reduce the activity of the osteoclastic process and relief patients'pain in the treatment of POP.

Objective To study the influence of eleutheroside E (ELE)on the learning and memory abilities of mice in-duced by para-chlorophenylalanine (PCPA) and on hippocampus′monoamine neurotransmitters of serotonin(5-HT) ,5-hydrox-indole acetic acid (5-HIAA) ,dopamine (DA) and norepinephrine (NA) .Methods Balb/c mice were randomized into control group ,model group ,positive group and three treatment groups (high ,moderate and low dose group) .The mouse injury model was established by PCPA abdominal injection .The mice′s abilities of learning and memory were detected in the Morris water maze test after 14 days of prevention medicine .The contents of 5-HT ,5-HIAA ,DA and NA in mice′s hippocampus were de-tected by Elisa kit .Results The behavior results showed that ,compared with control group ,the times across the platform by model group decreased significantly (P<0 .01) .The times across the platform by high and moderate dose groups increased sig-nificantly (P<0 .01) after the administration of ELE .The contents of 5-HT and 5-HIAA of the model group were lower than those of the control group (P<0 .01) .The contents of NA was lower too (P<0 .05) .The contents of 5-HT and 5-HIAA of different dose groups were much higher than those of the model group .Conclusion The enhancement of learning and memory ability in the mouse injury model established by PCPA might be related with the improvement of the contents of 5-HT ,5-HIAA ,DA ,NA in mice′s hippocampus by ELE .