This study selected 6 529 plant-based Chinese materia medica(PCMM) from Chinese Materia Medica as research subjects and applied a random permutation test to explore the overall correlation characteristics between nature and flavor, as well as the correlation characteristics after distinguishing different medicinal parts and harvest seasons. The results showed that the overall correlation characteristics between nature and flavor in PCMM were significantly associated in the following pairs: cold and bitter, cool and bitter, cool and astringent, cool and light, neutral and sweet, neutral and astringent, neutral and light, neutral and sour, hot and pungent, and warm and pungent. When analyzing the data by distinguishing medicinal parts and/or harvest seasons, new correlation patterns emerged, characterized by the disappearance of some significant correlations and the emergence of new ones. When analyzing by medicinal parts alone, significant correlations were found in the following cases: cold and light in leaves, cold and salty in barks, cool and sweet in fruits and seeds, neutral and pungent in whole herbs, neutral and salty in stems, and warm and salty in flowers. However, no significant correlations were found between cool and bitter in stems and other types of herbs, cool and astringent in fruits, seeds, flowers, and other types of herbs, cool and light in leaves, fruits, seeds, barks, flowers and other types of herbs, neutral and sweet in barks, neutral and astringent in whole herbs and stems, neutral and light in leaves, fruits, seeds, and flowers, neutral and sour in whole herbs, stems, barks, flowers, and other types of herbs, and hot and pungent in whole herbs, stems, flowers, and other types of herbs. When analyzing by harvest season alone, significant correlations were found in the following cases: cold and salty, and cool and sour in herbs harvested in winter, and neutral and salty in herbs harvested year-round. However, no significant correlation was found between cool and light in herbs harvested in winter. When considering both medicinal parts and harvest seasons, compared to the independent influence of medicinal parts, 14 new significant correlations emerged(e.g., the correlation between cool and bitter in stems harvested in spring), while 53 previously significant correlations disappeared(e.g., the correlation between cool and bitter in barks harvested in summer). Compared to the independent influence of harvest seasons, 11 new significant correlations appeared(e.g., the correlation between cold and light in barks harvested in autumn), while 50 previously significant correlations disappeared(e.g., the correlation between hot and pungent in leaves harvested in winter). This study is the first to reveal the influence of medicinal parts and harvest seasons on the correlation between nature and flavor in PCMM, which highlights that these two factors can interact and jointly affect nature-flavor correlations. Further research is needed to explore the underlying mechanisms. This study provides a deeper understanding of the inherent scientific connotations of herbal properties and offers a theoretical foundation for the cultivation and harvesting of PCMM.
Seasons ; Plants, Medicinal/growth & development* ; Drugs, Chinese Herbal/chemistry* ; Taste

Objective To explore the public's cognition and attitude towards general medicine,general practitioners,and pre-hospital first-aid knowledge in Ludian County,Yunnan Province,to find out the training and learning methods that are more acceptable to the public for this kind of related knowledge,and to propose targeted solutions.Methods A complete random sampling survey was conducted among the nucleic acid collection office at the gate of the vegetable market from October 15,2022,to December 30,2022,and the outpatient clinic of Wenping Street Health Center from January 1,2023,to February 28,2023,by using electronic questionnaire and paper questionnaire.Results Nearly 50%of the people in Ludian County of Yunnan Province lack the knowledge of general medicine and pre-hospital emergency care,especially the knowledge of electrical defibrillation.People with higher education and the medical profession have a higher understanding of general medicine,and people with a higher understanding of general medicine are more willing to participate in pre-hospital emergency care.The average Ridit value is:very familiar with general medicine(0.774)>Knowledge of some general practices(0.565)>Never heard of general practice(0.400).The higher education level and the more comprehensive understanding of general medicine had a positive impact on participation in pre-hospital emergency care,with B values of 0.624 and 0.619,OR 95%CI of 1.867(1.544～2.257)and 1.857(1.298～2.657),respectively.Taking medical staff as a reference,the B value of medical students was = 0.942,P = 0.234,the difference was not significant,and the B value of non-medical professional population was all less than 0,the effect is negative.In addition,most people have a positive attitude towards learning pre-hospital first aid,and more than 70%of people are willing to learn and train related knowledge of pre-hospital first aid.Conclusions People in urban areas of Ludian County,Yunnan Province have poor understanding of general practice,low recognition of general practitioners,low demand for general practitioners,and lack of awareness of the importance of pre-hospital emergency treatment.Because of the cognitive differences among different groups,it is necessary to conduct specific training for different groups.

Based on the theory of engineering medicine,a consensus which takes the basic medical ethics of harm reduction as the starting point is proposed to addresses the current clinical problems of a wide variety of radiotherapy setup equipments and methods,large differences by principles,and inaccurate setup.The consensus is formed in two aspects.(1)Advocate coordination of multiple setup methods for joint setup;collect,compare,analyze and screen data on setup methods;determine the operational guidelines and methods for joint setup based on the principle of standardized and unified clinical consistency,with a view to achieving the clinical purpose of greatly ensuring the precision of radiotherapy setup and radiotherapy safety without relying on the golden standard.(2)Standardize the operational methods for tracing setup deviations,so that when the difference in setup leads to poor clinical consistency,the cause of deviation can be traced and the effectiveness of different setups can be screened.Based on the concept of engineering medicine,the consensus is expected to standardize the method of radiotherapy setup,realize accurate radiotherapy,improve treatment effect and show medical ethical care.

Based on the theory of engineering medicine,a consensus which takes the basic medical ethics of harm reduction as the starting point is proposed to addresses the current clinical problems of a wide variety of radiotherapy setup equipments and methods,large differences by principles,and inaccurate setup.The consensus is formed in two aspects.(1)Advocate coordination of multiple setup methods for joint setup;collect,compare,analyze and screen data on setup methods;determine the operational guidelines and methods for joint setup based on the principle of standardized and unified clinical consistency,with a view to achieving the clinical purpose of greatly ensuring the precision of radiotherapy setup and radiotherapy safety without relying on the golden standard.(2)Standardize the operational methods for tracing setup deviations,so that when the difference in setup leads to poor clinical consistency,the cause of deviation can be traced and the effectiveness of different setups can be screened.Based on the concept of engineering medicine,the consensus is expected to standardize the method of radiotherapy setup,realize accurate radiotherapy,improve treatment effect and show medical ethical care.

BACKGROUND: Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion. METHODS: Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test). RESULTS: We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies. CONCLUSION: The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries. TRIAL REGISTRATION ClinicalTrials.gov, NCT01597232.
Humans ; Adult ; Postoperative Complications ; Erythrocyte Transfusion/adverse effects* ; Blood Transfusion ; Hospitals ; Hemoglobins/analysis*

Dao-di herbs are the treasure of Chinese materia medica and one of the characteristic research objects of traditional Chinese medicine(TCM). Probing into the microevolution of Dao-di herbs can help to reveal their biological essence and quality formation mechanisms. The progress in molecular biology and omics provides the possibility to elucidate the phylogenetic and quality forming characteristics of Dao-di herbs at the molecular level. In particular, genomics serves as a powerful tool to decipher the genetic origins of Dao-di herbs, and molecular markers have been widely used in the research on the genetic diversity and population structure of Dao-di herbs. Focusing on the excellent traits and quality of Dao-di herbs, this paper reviews the studies about the microevolution process of quality formation mechanisms of Dao-di herbs with the application of molecular markers and omics, aiming to underpin the protection and utilization of TCM resources.
Drugs, Chinese Herbal ; Phylogeny ; Plants, Medicinal/chemistry* ; Medicine, Chinese Traditional ; Phenotype

Objective To investigate the characteristics of clinical cellular immunity and its relationship with prognosis in elderly patients with severe infection caused by Omicron variant.Methods The clinical data of 53 patients with Omicron variant infection admitted to the geriatric Intensive Care Unit of the First Affiliated Hospital of Kunming Medical University from December 2022 to February 2023 were retrospectively analyzed.The patients were divided into 22 survival cases and 31 death cases for comparison between the two groups.Logistic analysis is adopted to define the omicron variants of elderly severe infections prognostic factors and construct the ROC curve.Results Mu-ltivariate logistic analysis revealed that the independent risk factors were elevated IL-6(P = 0.043)and decreased absolute T lymphocyte count(P = 0.011).AUC value of ROC of IL-6,absolute T lymphocyte count and IL-6 combined with absolute T lymphocyte count was 0.818,0.796 and 0.887.Conclusion Elevated IL-6 and decreased absolute T lymphocyte count are independent risk factors for elderly severe patients with Omicron variant infections.

A rich diversity of wild medicinal plant resources is distributed in China, but the breeding of new plant varieties of Chinese medicinal plants started late and the breeding level is relatively weak. Chinese medicinal plant resources are the foundation for new varieties breeding, and the plant variety rights(PVP) are of great significance for the protection and development of germplasm resources. However, most Chinese medicinal plants do not have a distinctness, uniformity, and stability(DUS) testing guideline. The Ministry of Agriculture and Rural Affairs has put 191 plant species(genera) on protection lists, of which only 30 are medicinal species(genera). At the same time, only 29 of 293 species(genera) plants in the Protection List of New Plant Varieties of the People's Republic of China(Forest and Grass) belong to Chinese medicinal plants. The number of PVP applications and authorization of Chinese medicinal plants is rare, and the composition of variety is unreasonable. Up to now, 29 species(genera) of DUS test guidelines for Chinese medicinal plants have been developed. Some basic problems in the breeding of new varieties of Chinese medicinal plants have appeared, such as the small number of new varieties and insufficient utilization of Chinese medicinal plant resources. This paper reviewed the current situation of breeding of new varieties of Chinese medicinal plants and the research progress of DUS test guidelines in China and discussed the application of biotechnology in the field of Chinese medicinal plant breeding and the existing problems in DUS testing. This paper guides the further application of DUS to protect and utilize the germplasm resources of Chinese medicinal plants.
Agriculture ; Biotechnology ; Plant Breeding ; Plants, Medicinal/genetics*

Chinese medicinal resources are the cornerstone of the sustainable development of traditional Chinese medicine industry. However, due to the fecundity of species, over-exploitation, and limitations of artificial cultivation, some medicinal plants are depleted and even endangered. Tissue culture, a breakthrough technology in the breeding of traditional Chinese medicinal materials, is not limited by time and space, and can allow the production on an annual basis, which plays an important role in the protection of Chinese medicinal resources. The present study reviewed the applications of tissue culture of medicinal plants in the field of Chinese medicinal resources, including rapid propagation of medicinal plant seedlings, breeding of novel high-yield and high-quality cultivars, construction of a genetic transformation system, and production of secondary metabolites. Meanwhile, the current challenges and suggestions for the future development of this field were also proposed.
Sustainable Development ; Plants, Medicinal/genetics* ; Plant Breeding ; Medicine, Chinese Traditional ; Technology

Objective To study the predictive value of lung ultrasound score(LUS) on the extubation success rate in the patients with mechanical ventilation for early identifying the high risk patients with extubation failure and guiding the sequential therapy after extubation.Methods The prospective study method was adopted.Eighty-one cases with mechanical ventilation exceeding 48 h and successfully passing the spontaneous breathing trial(SBT) in EICU were selected.The bedside LUS evaluation was conducted before extubation.The cases were divided into the two groups according to whether successfully weaning.And the LUS differences before extubation were compared between the two groups.The receiver operating characteristic(ROC) curve was used to evaluate the predictive efficiency for extubation failure.Results The age and sex had no statistical difference between the two groups(P＞0.05).In included 81 cases,27 cases were failed to extubation and appeared different degrees of respiratory distress sign:respiratory rate(RR) increase,heart rate(HR) increase,SpO2 decrease,etc.,which needed non-invasive mechanical ventilation or high flow nasal cannula oxygen for alleviating respiratory difficulty.In the extubation failure group,10 cases were ineffective by above treatment and then needed reintubation.One case died within 24 h after extubation.Fifty-four cases succeeded in weaning and extubation.The LUS score was positively correlated with RR and PaCO2 (r=0.43,0.62;P＜0.05) and negatively correlated with SpO2 and PaO2(r=-0.76,-0.58;P＜0.05),while it was not correlated with HR and pH value(r=0.15,0.02,P＞0.05).The area under the ROC curve (AUC) of LUS score was 0.90(95％CI:0.84-0.95),it could be regarded that the accuracy of LUS for predicting extubation failure rate was stable,its sensitivity was 0.84 and specificity was 0.80.The diagnostic cutoff value was 15.00,if the LUS score exceeding 15 points,the extubation failure rate was significantly increased.Conclusion The LUS score has clinical application value for assessing the extubation success rate in the patients with mechanical ventilation.The patients with high risk of extubation failure can be early identified by the LUS score,which can guide the sequential therapy after extubation.